Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2024-04-09 DOI:10.1002/micr.31177

Hyung Bae Kim M.D., Young Song Kim M.D., Jin Sup Eom M.D., Ph.D., Hyun Ho Han M.D., Ph.D.

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引用次数: 0

Abstract

Background

Several alternative flaps have been introduced and used for autologous breast reconstruction. However, as body fat distribution is different among patients, the donor of choice for sufficient breast projection varies between patients.

Methods

Patients who underwent autologous breast reconstruction from Jan 2018 to Sep 2022 were included. Age, body mass index (BMI), smoking history and hypertension, and diabetes occurrence were collected as baseline demographic data. Breast projection with five types of flap thickness was measured based on computed tomography angiography. Analysis was performed for five major autologous flaps for breast reconstruction.

Results

A total of 563 patients were included in the study. The mean age of the patients was 47.4 ± 7.9 (standard deviation; SD) years. The mean BMI of the patients was 24.0 ± 3.4 kg/m². Only the correlation between flap thickness to breast projection ratio and age in the PAP flap illustrated statistical significance (p = .039), but the correlation coefficient was quite low (r = −0.087). Slim patients who had lower BMIs (under 25 kg/m²) had significantly higher sufficient flap thickness for breast reconstruction than patients with higher BMIs over 25 kg/m² in the profunda artery perforator (PAP) flap (p < .001), the lumbar artery perforator (LAP) flap (p < .001), and the superior gluteal artery perforator (SGAP) flap (p < .001).

Conclusions

The deep inferior epigastric perforator flap provided sufficient thickness and was not usually affected by age and BMI. The PAP, LAP, and SGAP flaps tended to maintain the thickness of the flap even when BMI decreased, so they are advantageous for reconstruction in slim patients. This study contributes evidence in consideration of flap selection in autologous breast reconstruction.

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东亚女性皮瓣厚度与乳房投影比与体重指数和年龄的相关性分析：乳房重建中皮瓣选择的考虑因素

背景目前，已有多种替代性皮瓣被引入并用于自体乳房重建。然而，由于不同患者的身体脂肪分布不同，因此不同患者为获得足够的乳房投影而选择的供体也不尽相同。方法纳入 2018 年 1 月至 2022 年 9 月期间接受自体乳房重建的患者。收集年龄、体重指数（BMI）、吸烟史和高血压以及糖尿病发生率作为基线人口统计学数据。根据计算机断层扫描血管造影测量了五种皮瓣厚度的乳房投影。对用于乳房重建的五种主要自体皮瓣进行了分析。结果共有 563 名患者参与了研究。患者的平均年龄为 47.4 ± 7.9（标准差；SD）岁。患者的平均体重指数为 24.0 ± 3.4 kg/m2。只有 PAP 皮瓣厚度与乳房投影比和年龄之间的相关性具有统计学意义（p = .039），但相关系数很低（r = -0.087）。体重指数（BMI）较低（低于 25 kg/m2）的苗条患者的乳房重建所需的足够皮瓣厚度明显高于体重指数超过 25 kg/m2 的患者，在深部动脉穿孔器（PAP）皮瓣（p < .001）、腰动脉穿孔器（LAP）皮瓣（p < .001）和臀上动脉穿孔器（SGAP）皮瓣（p < .001）中均是如此。结论下腹深部穿孔器皮瓣具有足够的厚度，通常不受年龄和体重指数的影响。即使体重指数下降，PAP、LAP 和 SGAP 皮瓣也能保持皮瓣的厚度，因此它们在瘦弱患者的重建中具有优势。这项研究为考虑自体乳房重建中皮瓣的选择提供了证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.