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Post-operative outcomes of abdominal mesh placement in deep inferior epigastric perforator flap reconstruction
Rachel E. Schafer, Shannon S. Wu, Priya Shukla, Steven Bernard MD, Graham Schwarz MD, Sarah N. Bishop MD, Risal Djohan MD, Raffi Gurunian MD
Department of Plastic Surgery, Cleveland Clinic
2023-01-14
Presenter: Rachel E Schafer
Affidavit:
I agree with the breakdown of work outlined below for Rachel Schafer.
Director Name: Steven Bernard
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Abdominal surgeries such as deep inferior epigastric perforator flap (DIEP) reconstruction may weaken the abdominal wall and increase risk of postoperative herniation. The practice of abdominal mesh placement after DIEP reconstruction is largely provider dependent. This study seeks to characterize demographic trends and outcomes for patients receiving abdominal mesh during DIEP breast reconstruction.
Methods: This retrospective study included patients who underwent DIEP breast reconstruction between January 2019 and July 2022 at a single academic institution. Demographics and outcomes were compared using two-sample t-test or Chi-square analysis.
Results: Overall, 355 patients were included, with 176 (50%) patients who received abdominal mesh and 179 (%) who did not receive mesh. The abdominal mesh cohort had longer hospital length of stay (4.0 d vs. 3.0 d, p<0.001). There were no significant differences in age (51 years vs 50 years), BMI (29.0 vs 28.0), history of diabetes (12% vs 7.3%), length of surgery (8.97 hr vs 9.73 hr), rate of hospital readmission (9.1% vs 6.7%), reoperation (15% vs 12%), or postoperative abdominal hernia rate (3.4% vs 2.8%) in mesh versus no mesh cohorts, respectively.
Conclusions: Patients receiving abdominal mesh had no differences in safety and surgical outcomes when compared to those who did not receive abdominal mesh during DIEP breast reconstruction. Further research is needed to determine risk factors for post-operative abdominal hernias and characterization of patient populations who may benefit from abdominal mesh placement in order to enhance patient safety and cost-effectiveness.
