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Sensate autologus breast reconstruction and patient reported outcomes
Isis Scomacao MD, Rebecca Knackstedt MD, PhD, Eliana Duraes MD, PhD, Cagri Cakmakoglu MD, Graham Schwarz MD, Andrea Moreira MD, Risal Djohan, MD
Cleveland Clinic
2020-02-15
Presenter: Isis Scomacao
Affidavit:
I certify that this represents the original work of the resident.
Director Name: Steven Bernard
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose:The aim of this study is to evaluate patient-reported and breast sensory outcomes after utilizing our novel approach to sensate DIEP breast reconstruction with a nerve allograft and conduit.
Methods: Sensation recovery tests were performed of consecutive patients who underwent DIEP reconstruction with (group 1) and without (group 2) neurotization. Breast-Q was answered post-operatively. Demographic information, surgical details, and post-operative complications were also analyzed.
Results:A total of 74 patients (96 breasts) underwent this technique between June 2016 and December 2018. Thirty-eight patients (61 breasts) underwent sensory testing, and only these patients were subsequently analyzed. Of the 61 breasts, 46 had neurotization (group 1), and 15 did not (group 2). Compared to group 2, the neurotized group had better sensation thresholds during the first set of tests for 56.25% of the total areas evaluated (p=0.37). In the second round of testing, the clinical difference between the groups was more evident with improved sensation thresholds observed in the neurotized group for all areas at an average of 15 months of follow up. High satisfaction with outcome (73±23.3), satisfaction with breast (70.6±16.8), chest physical well-being (76±12.8), and psychosocial well-being (69.9±19) was observed. When comparing Breast-Q data with our historical cohort without neurotization, it was found higher scores in the physical well-being domain in this neurotized patients.
Conclusion:There is a positive trend for breast sensation recovery after reconstruction with neurotized DIEP flaps, and our early results show that patient-reported outcomes may also be improved by this increase in return of breast sensation.
