在腹部自体乳房重建中优先使用皮下动脉(SCIA-SB 和 SIEA)与改良皮瓣设计。

IF 1.5 Q3 SURGERY
Plastic and Reconstructive Surgery Global Open Pub Date : 2024-10-28 eCollection Date: 2024-10-01 DOI:10.1097/GOX.0000000000006252
Alberto Franchi, Luca Patanè, Carmen Elena Hummel, Jonas Walber, Shadi Najaf Zadeh, Abdul Rahman Jandali, Florian Jung
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引用次数: 0

摘要

背景:尽管下腹深动脉穿孔器皮瓣有很多优点,但它需要进行筋膜切口和肌肉内剥离,这会导致疼痛和腹壁减弱。上腹部浅动脉(SIEA)皮瓣为避免这种损伤提供了另一种选择,但由于其解剖结构多变,通常被认为是不可靠的。在本研究中,我们报告了使用髂周浅动脉浅支(SCIA-SB)或上腹部浅动脉作为唯一皮瓣蒂的自体乳房重建经验:方法:2022年8月至2023年12月进行了一项回顾性研究。共有 17 名患者接受了 18 个皮瓣的乳房重建(1 个双侧重建,16 个单侧重建)。SCIA-SB(14个皮瓣)或SIEA(4个皮瓣)是唯一的动脉来源。术前使用彩色双工超声进行血管识别,并相应调整皮瓣设计。术中通过吲哚菁绿血管造影术评估皮瓣灌注情况。记录人口统计学、术中和术后数据:平均随访时间为 5.7 个月(3-17 个月)。在 18 个皮瓣中,1 个因动脉供血不足而丢失。1例皮瓣部分坏死需要翻修,7例患者出现轻微并发症(血清肿、伤口裂开、乳房切除皮肤坏死和感染):根据我们的经验,SCIA-SB 或 SIEA 均可成功用作自体乳房重建的血管蒂,前提是腹部皮瓣的设计必须包括其功能性血管蒂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Preferential Use of Subcutaneous Arteries (SCIA-SB and SIEA) in Abdominal-based Autologous Breast Reconstruction with a Modified Flap Design.

Background: Despite its many advantages, the deep inferior epigastric artery perforator flap requires fascial incision and intramuscular dissection, which can lead to pain and weakening of the abdominal wall. The superficial inferior epigastric artery (SIEA) flap offers an alternative to avoid this damage but is often considered unreliable due to its variable anatomy. In this study, we report our experience in autologous breast reconstruction using either the superficial branch of the superficial circumflex iliac artery (SCIA-SB) or the SIEA as the sole flap pedicle.

Methods: A retrospective study was conducted from August 2022 to December 2023. A total of 17 patients underwent breast reconstruction with 18 flaps (1 bilateral and 16 unilateral reconstructions). The SCIA-SB (14 flaps) or SIEA (4 flaps) served as the exclusive arterial sources. Preoperative vessel identification was performed using color-coded duplex sonography, and the flap design was adjusted accordingly. Intraoperative flap perfusion was assessed via indocyanine green angiography. Demographic, intraoperative, and postoperative data were recorded.

Results: The mean follow-up was 5.7 months (range: 3-17 mo). Of the 18 flaps, 1 was lost due to arterial insufficiency. Partial flap necrosis requiring revision occurred in 1 case, whereas minor complications (seroma, wound dehiscence, mastectomy skin necrosis, and infection) were observed in 7 patients.

Conclusion: In our experience, either the SCIA-SB or SIEA can be successfully used as a pedicle in autologous breast reconstruction, provided that the abdominal flap design is modified to include their functional angiosomes.

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来源期刊
CiteScore
2.20
自引率
13.30%
发文量
1584
审稿时长
10 weeks
期刊介绍: Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.
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