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BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction

BACKGROUND: Patients undergoing bilateral autologous breast reconstruction may benefit from increased flap volume using bilateral stacked deep inferior epigastric perforator (DIEP) and profunda artery perforator (PAP) flaps. Our aim was to characterize the donor site morbidity and patient-reported o...

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Autores principales: Haddock, Nicholas T., Dickey, Ryan M., Perez, Kevin, Garza, Ricardo, Liu, Yulun, Teotia, Sumeet S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324622/
https://www.ncbi.nlm.nih.gov/pubmed/35923986
http://dx.doi.org/10.1097/GOX.0000000000004413
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author Haddock, Nicholas T.
Dickey, Ryan M.
Perez, Kevin
Garza, Ricardo
Liu, Yulun
Teotia, Sumeet S.
author_facet Haddock, Nicholas T.
Dickey, Ryan M.
Perez, Kevin
Garza, Ricardo
Liu, Yulun
Teotia, Sumeet S.
author_sort Haddock, Nicholas T.
collection PubMed
description BACKGROUND: Patients undergoing bilateral autologous breast reconstruction may benefit from increased flap volume using bilateral stacked deep inferior epigastric perforator (DIEP) and profunda artery perforator (PAP) flaps. Our aim was to characterize the donor site morbidity and patient-reported outcomes in four-flap breast reconstruction. METHODS: Retrospective review was performed for all patients undergoing four-flap breast reconstruction by two surgeons between January 2010 and September 2021. Outcome measures including the BREAST-Q reconstructive module, the lower extremity functional scale (LEFS), inpatient surgical site pain scores by numeric pain rating scale (NPRS), and a postoperative subjective survey comparing donor sites were obtained. Four-flap BREAST-Q scores were compared with bilateral DIEP and bilateral PAP patients. RESULTS: A total of 79 patients undergoing four-flap breast reconstruction were identified. Four-flap BREAST-Q scores (n = 56) were similar to bilateral DIEP and bilateral PAP reconstruction patients. Long-term survey outcomes from the LEFS demonstrated improved score trend after 6 months. Mean instances of donor site pain location recorded at the abdomen were significantly higher than the thigh during the postoperative admission. Subjective survey data revealed more long-term donor site pain at the PAP site, a patient preference for the DIEP donor site, and easier postoperative care for the DIEP donor site. CONCLUSIONS: This is the largest consecutive series of four-flap breast reconstruction outcomes reported to date. BREAST-Q scores in four-flap patients demonstrate overall patient satisfaction that is similar to both bilateral DIEP and bilateral PAP reconstruction patients. The DIEP donor site appears to be preferred by patients over the PAP donor site.
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spelling pubmed-93246222022-08-02 BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction Haddock, Nicholas T. Dickey, Ryan M. Perez, Kevin Garza, Ricardo Liu, Yulun Teotia, Sumeet S. Plast Reconstr Surg Glob Open Breast BACKGROUND: Patients undergoing bilateral autologous breast reconstruction may benefit from increased flap volume using bilateral stacked deep inferior epigastric perforator (DIEP) and profunda artery perforator (PAP) flaps. Our aim was to characterize the donor site morbidity and patient-reported outcomes in four-flap breast reconstruction. METHODS: Retrospective review was performed for all patients undergoing four-flap breast reconstruction by two surgeons between January 2010 and September 2021. Outcome measures including the BREAST-Q reconstructive module, the lower extremity functional scale (LEFS), inpatient surgical site pain scores by numeric pain rating scale (NPRS), and a postoperative subjective survey comparing donor sites were obtained. Four-flap BREAST-Q scores were compared with bilateral DIEP and bilateral PAP patients. RESULTS: A total of 79 patients undergoing four-flap breast reconstruction were identified. Four-flap BREAST-Q scores (n = 56) were similar to bilateral DIEP and bilateral PAP reconstruction patients. Long-term survey outcomes from the LEFS demonstrated improved score trend after 6 months. Mean instances of donor site pain location recorded at the abdomen were significantly higher than the thigh during the postoperative admission. Subjective survey data revealed more long-term donor site pain at the PAP site, a patient preference for the DIEP donor site, and easier postoperative care for the DIEP donor site. CONCLUSIONS: This is the largest consecutive series of four-flap breast reconstruction outcomes reported to date. BREAST-Q scores in four-flap patients demonstrate overall patient satisfaction that is similar to both bilateral DIEP and bilateral PAP reconstruction patients. The DIEP donor site appears to be preferred by patients over the PAP donor site. Lippincott Williams & Wilkins 2022-07-25 /pmc/articles/PMC9324622/ /pubmed/35923986 http://dx.doi.org/10.1097/GOX.0000000000004413 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/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) (https://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 Breast
Haddock, Nicholas T.
Dickey, Ryan M.
Perez, Kevin
Garza, Ricardo
Liu, Yulun
Teotia, Sumeet S.
BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction
title BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction
title_full BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction
title_fullStr BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction
title_full_unstemmed BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction
title_short BREAST-Q and Donor Site Comparison in Bilateral Stacked Autologous Breast Reconstruction
title_sort breast-q and donor site comparison in bilateral stacked autologous breast reconstruction
topic Breast
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324622/
https://www.ncbi.nlm.nih.gov/pubmed/35923986
http://dx.doi.org/10.1097/GOX.0000000000004413
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