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Impact of Breast volume excision and complications with free flap reconstructions

Harry S. Nayar B.A.1; Julio A. Clavijo-Alvarez MD. PhD1.; Vu T. Nguyen MD1; Michael L. Gimbel MD1; Carolyn De La Cruz MD1
University of Pittsburgh Medical center
2012-02-15

Presenter:

Affidavit:
100% of the work was performed by the presentor

Director Name: Joseph Losee

Author Category: Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

How does this presentation meet the established conference educational objectives?
this study elucidates the impact of breast volume excision and outcomes with free flap reconstructions

How will your presentation be used by practicing physicians in the audience?
Analysis of outcomes will improve patient selection for improved reconstructions

Background: Immediate autogenous breast reconstruction utilizing the abdominal wall is an attractive option for locoregional management of breast cancer in properly selected patients. Typically, an oncologic breast surgeon performs the mastectomy that is then followed by the reconstructive efforts of plastic surgery. We hypothesized that the breast tissue volume removed affect the outcomes usually ascribed to plastic surgery.

Methods: 37 breast reconstructions were performed. Demographics, surgical breast volumes and outcomes were tabulated. Averages and standard deviations were provided for continuous variables. Chi-squares and odds ratios were calculated for binomial variables. P <0.05 was considered significant.

Results: Average age 50 ± 6.6 .BMI 26.8 ± 3.2. A total of 13 (35%) complications in the breast were found including: Hematoma: (3/37; 8%); seroma 4/37 (11%); Dehiscence: (1/37; 3%); Infection: (1/37; 3%); fat necrosis: (4/37; 11%); mastectomy flap necrosis: (1/37; 3%); flap thorombosis: (1/37; 3%). Only fat necrosis was correlated with the volume of tissue removed. (p<0.05)

Conclusions: there is no correlation between the excised volume and most of the complications after breast reconstruction with free flaps. Only fat necrosis was associated with the volume of tissue removed.

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