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Is Visceral Adipose Tissue / Subcutaneous Adipose tissue ratio more predictive of local and systemic adverse outcomes in patients with DIEP flap breast reconstruction than BMI ? A retrospective CT sca
Moheb Said MD, PhD
Cody Derek MD
Wagner Douglas MD
Summa Health Care System
2019-02-15
Presenter: Moheb Said MD, PhD
Affidavit:
All of the work in the submitted abstract was done by the presenter and the Program Director is aware and approved the Abstract.
Director Name: Douglas Wagner. MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background
As BMI increases, the risk of DIEP flap used for breast reconstruction and its donor site complications increases. A BMI of 40 was identified as a threshold at which the prevalence of complications became prohibitively high. BMI is a product of 2 variables, the patient weight and height, placing short patients in a disadvantage. On the other hand, Central Obesity has 2 components, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT).
Visceral adipose tissue, secrets multiple pro-inflammatory cytokines, and is strongly
associated with insulin resistance that increases the incidence of autologous free flap and donor site complications e.g total/partial flap necrosis, fat necrosis, hernia, bulge and even DVT (3-4).
SAT and increasing flap weight has been linked to increasing flap complication rates
We postulate that central obesity (VAT / STA ratio) will be more predictive of adverse outcome than a BMI is in free autologous breast reconstruction patients.Material and methods
A retrospective analysis of local and systemic adverse outcomes in DIEP breast reconstruction patients between January 2017 and April 2019 comparing the effect of BMI vs VAT/SAT ratio on adverse outcomes. The VAT/SAT ratio will be calculated utilizing the CTA ordered preoperatively for perforator mapping.
Results
Our preliminary findings indicates that the VAT/SAT ratio is more predictive of adverse outcomes in DIEP flap breast reconstruction compared to the BMI
Conclusion:
VAT/SAT ratio is an easy parameter to obtain using the CTA scan ordered preoperatively for perforator mapping and is a better predictive of adverse outcome in DIEP flap breast reconstruction than BMI
