TY - JOUR
T1 - Changing trends in recipient vessel selection for microvascular autologous breast reconstruction
T2 - An analysis of 1483 consecutive cases
AU - Saint-Cyr, Michel
AU - Youssef, Adel
AU - Bae, Hyung Woon
AU - Robb, Geoffrey L.
AU - Chang, David W.
PY - 2007/6
Y1 - 2007/6
N2 - BACKGROUND: Over the years, the authors' preferred recipient vessels for microvascular autologous breast reconstruction have changed from the thoracodorsal to the internal mammary vessels. METHODS: From 1994 to 2004, 1483 microvascular autologous breast reconstructions were performed in 1168 patients at the authors' institution. Potential factors involved in the selection of the recipient vessels were evaluated and compared between the thoracodorsal and internal mammary groups. Rates of recipient vessel unusability and flap-related complications were also analyzed and compared between the two groups. RESULTS: The mean patient age was 48 years, and the mean follow-up time was 1.5 years. The vessel conversion rate was 2.8 percent for the thoracodorsal group and 1.9 percent for the internal mammary group. Preoperative radiotherapy and previous axillary node dissection were significantly associated with thoracodorsal vessel conversion (odds ratios, 4.7 and 2.6, respectively). The overall flap-related complication rate (12.6 percent versus 8.6 percent) and specific flap-related complications, including flap loss (2.6 percent versus 3.8 percent), vessel thrombosis (3.7 percent versus 5.0 percent), fat necrosis (4.5 percent versus 2.6 percent), infection (0.7 percent versus 0.7 percent), and hematoma (1.6 percent versus 1.9 percent), were comparable between the two groups, but the flap seroma rate was significantly higher in the thoracodorsal group (4.0 percent versus 0.7 percent; odds ratio, 4.2). CONCLUSION: In the authors' experience, use of internal mammary vessels is safe, with low rates of vessel conversion and flap-related complications.
AB - BACKGROUND: Over the years, the authors' preferred recipient vessels for microvascular autologous breast reconstruction have changed from the thoracodorsal to the internal mammary vessels. METHODS: From 1994 to 2004, 1483 microvascular autologous breast reconstructions were performed in 1168 patients at the authors' institution. Potential factors involved in the selection of the recipient vessels were evaluated and compared between the thoracodorsal and internal mammary groups. Rates of recipient vessel unusability and flap-related complications were also analyzed and compared between the two groups. RESULTS: The mean patient age was 48 years, and the mean follow-up time was 1.5 years. The vessel conversion rate was 2.8 percent for the thoracodorsal group and 1.9 percent for the internal mammary group. Preoperative radiotherapy and previous axillary node dissection were significantly associated with thoracodorsal vessel conversion (odds ratios, 4.7 and 2.6, respectively). The overall flap-related complication rate (12.6 percent versus 8.6 percent) and specific flap-related complications, including flap loss (2.6 percent versus 3.8 percent), vessel thrombosis (3.7 percent versus 5.0 percent), fat necrosis (4.5 percent versus 2.6 percent), infection (0.7 percent versus 0.7 percent), and hematoma (1.6 percent versus 1.9 percent), were comparable between the two groups, but the flap seroma rate was significantly higher in the thoracodorsal group (4.0 percent versus 0.7 percent; odds ratio, 4.2). CONCLUSION: In the authors' experience, use of internal mammary vessels is safe, with low rates of vessel conversion and flap-related complications.
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U2 - 10.1097/01.prs.0000260636.43385.90
DO - 10.1097/01.prs.0000260636.43385.90
M3 - Article
C2 - 17519690
AN - SCOPUS:34249803233
SN - 0032-1052
VL - 119
SP - 1993
EP - 2000
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 7
ER -