Cargando…

Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction

This study aimed to assess the extent of rectus muscle damage in deep inferior epigastric perforator (DIEP) flap harvest and to evaluate its association with functional donor morbidity. METHODS: A prospective cohort of 76 patients who underwent DIEP flap breast reconstruction was evaluated preoperat...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Kyeong-Tae, Park, Jin-Woo, Mun, Goo-Hyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6846286/
https://www.ncbi.nlm.nih.gov/pubmed/31772905
http://dx.doi.org/10.1097/GOX.0000000000002484
_version_ 1783468849575755776
author Lee, Kyeong-Tae
Park, Jin-Woo
Mun, Goo-Hyun
author_facet Lee, Kyeong-Tae
Park, Jin-Woo
Mun, Goo-Hyun
author_sort Lee, Kyeong-Tae
collection PubMed
description This study aimed to assess the extent of rectus muscle damage in deep inferior epigastric perforator (DIEP) flap harvest and to evaluate its association with functional donor morbidity. METHODS: A prospective cohort of 76 patients who underwent DIEP flap breast reconstruction was evaluated preoperatively and followed up for 1 year. Abdominal wall strength was assessed using the upper and lower rectus abdominis manual muscle function tests. Functional weakness was defined as a postoperative decrease in function by at least 2 scores. The effects of patient- and operation-related characteristics on adverse outcomes were also assessed. RESULTS: The mean width of the transected rectus muscle was 2.2 cm (partial thickness, 1.8 cm; full thickness, 0.4 cm). The mean width ratio of the overall injured muscle to the entire bilateral muscle was 0.18. Muscle injury was more severe in the cases with bipedicled flap elevation and in those with 4 or more perforators harvested. Functional weakness was detected in 13 patients (17.1%). Multivariate analyses demonstrated that the width ratio of the muscle injury was an independent predictor of functional weakness. The width ratio achieved maximal discrimination regarding the rate of functional weakness at a threshold value of 0.12, indicating that functional weakness did not develop in all 19 cases with a width ratio of <0.12. CONCLUSIONS: The extent of rectus muscle injury during perforator dissection may be associated with functional donor morbidity after DIEP flap harvest. This may be beneficial in achieving proper balance between securing flap perfusion and preserving donor functions.
format Online
Article
Text
id pubmed-6846286
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-68462862019-11-26 Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction Lee, Kyeong-Tae Park, Jin-Woo Mun, Goo-Hyun Plast Reconstr Surg Glob Open Original Article This study aimed to assess the extent of rectus muscle damage in deep inferior epigastric perforator (DIEP) flap harvest and to evaluate its association with functional donor morbidity. METHODS: A prospective cohort of 76 patients who underwent DIEP flap breast reconstruction was evaluated preoperatively and followed up for 1 year. Abdominal wall strength was assessed using the upper and lower rectus abdominis manual muscle function tests. Functional weakness was defined as a postoperative decrease in function by at least 2 scores. The effects of patient- and operation-related characteristics on adverse outcomes were also assessed. RESULTS: The mean width of the transected rectus muscle was 2.2 cm (partial thickness, 1.8 cm; full thickness, 0.4 cm). The mean width ratio of the overall injured muscle to the entire bilateral muscle was 0.18. Muscle injury was more severe in the cases with bipedicled flap elevation and in those with 4 or more perforators harvested. Functional weakness was detected in 13 patients (17.1%). Multivariate analyses demonstrated that the width ratio of the muscle injury was an independent predictor of functional weakness. The width ratio achieved maximal discrimination regarding the rate of functional weakness at a threshold value of 0.12, indicating that functional weakness did not develop in all 19 cases with a width ratio of <0.12. CONCLUSIONS: The extent of rectus muscle injury during perforator dissection may be associated with functional donor morbidity after DIEP flap harvest. This may be beneficial in achieving proper balance between securing flap perfusion and preserving donor functions. Wolters Kluwer Health 2019-10-29 /pmc/articles/PMC6846286/ /pubmed/31772905 http://dx.doi.org/10.1097/GOX.0000000000002484 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Lee, Kyeong-Tae
Park, Jin-Woo
Mun, Goo-Hyun
Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction
title Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction
title_full Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction
title_fullStr Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction
title_full_unstemmed Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction
title_short Impact of Rectus Muscle Injury during Perforator Dissection on Functional Donor Morbidity after Deep Inferior Epigastric Perforator Flap Breast Reconstruction
title_sort impact of rectus muscle injury during perforator dissection on functional donor morbidity after deep inferior epigastric perforator flap breast reconstruction
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6846286/
https://www.ncbi.nlm.nih.gov/pubmed/31772905
http://dx.doi.org/10.1097/GOX.0000000000002484
work_keys_str_mv AT leekyeongtae impactofrectusmuscleinjuryduringperforatordissectiononfunctionaldonormorbidityafterdeepinferiorepigastricperforatorflapbreastreconstruction
AT parkjinwoo impactofrectusmuscleinjuryduringperforatordissectiononfunctionaldonormorbidityafterdeepinferiorepigastricperforatorflapbreastreconstruction
AT mungoohyun impactofrectusmuscleinjuryduringperforatordissectiononfunctionaldonormorbidityafterdeepinferiorepigastricperforatorflapbreastreconstruction