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Prognostic Value of Sarcopenia in Patients Undergoing Autologous Breast Reconstruction with Free Tissue Transfer
Eric Pittelkow, MD
Will Debrock, BS
Briana McLaughlin, BS
Aladdin Hassanein, MD
Juan Socas, MD
Mary Lester, MD
Steve Duquette, MD
Indiana University School of Medicine, Division of Plastic Surgery
2018-01-30
Presenter: Eric Pittelkow, MD
Affidavit:
The residents are responsible for 100% of the original work in this abstract
Director Name: William Wooden
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction:
Sarcopenia is a condition characterized by the loss of skeletal muscle mass and function. Sarcopenia has been shown to be a significant risk factor for surgical complications in the general surgery and thoracic literature. The purpose of this study was to compare clinical outcomes after free flap breast reconstruction in patients with and without sarcopenia.
Methods:
Consecutive patients undergoing free autologous breast reconstruction from 2013 to 2016 were included. The cross sectional area (CSA) of skeletal muscle was measured from preoperative CT images at L3 spine using the NIH ImageJ software. CSA was then normalized to height (cm2/m2). A previously published SMI less than or equal to 38.5 cm2/m2 was used to designate sarcopenia. Intraoperative and postoperative surgical outcomes were recorded retrospectively. Outcomes were analyzed using binomial logistic regression.
Results:
The study included 103 patients (7.8% sarcopenic). Sarcopenia was associated with a significant increase in flap site delayed healing (37.5% vs 20% p=.02), intraoperative complications (25% vs 2.1% p=.024, ICU length of stay (1.5 vs 0.02 days p<.0005), and hospital length of stay (8.38 vs 5.49 days p<.0005) when compared to patients without sarcopenia. There was no significant differences in flap loss, surgical site infection, hematoma, seroma, donor site delayed healing, take backs to the OR, and number of revision surgeries.
Conclusion:
Sarcopenia is a risk factor for increased complications and length of hospital/ICU stay in patients undergoing free flap breast reconstruction. Further investigation is needed to assess preoperative interventions to decrease the risk of complications in sarcopenic patients.
