{"title":"带蒂分割和可吸收网片加固的胸前植入物用于DIEP皮瓣增强。","authors":"Michael N Mirzabeigi","doi":"10.1097/PRS.0000000000012156","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to review the safety and efficacy of delayed prepectoral deep inferior epigastric perforator (DIEP) flap augmentation in both primary DIEP flap augmentation and revision DIEP flap augmentation (ie, prepectoral conversion).</p><p><strong>Methods: </strong>A retrospective review of records was performed on all patients who underwent primary and revision breast reconstruction from August of 2018 to August of 2024 performed by a single surgeon.</p><p><strong>Results: </strong>A total of 585 abdominally based free flaps were performed by the author during the aforementioned 6-year period. Thirty-two of these autologous reconstructions (5.5%) proceeded to undergo prepectoral DIEP flap augmentation. Thirty-two primary DIEP flaps and 8 prepectoral conversions (subpectoral DIEP flap augmentation to prepectoral DIEP flap augmentation) were performed. There were no acute flap-related complications caused by implant placement. Two implants experienced inferior malposition prompting the adoption of TIGR matrix support later in the series. Following the adoption of a resorbable mesh for soft-tissue support, there were no further cases of inferior malposition.</p><p><strong>Conclusions: </strong>Delayed prepectoral DIEP flap augmentation is a safe and effective means of hybrid breast reconstruction. Inferior soft-tissue support should be strongly considered, particularly with use of smooth implants, in this setting.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"444e-450e"},"PeriodicalIF":3.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prepectoral Implant Placement with Pedicle Division and Resorbable Mesh Reinforcement for DIEP Flap Augmentation.\",\"authors\":\"Michael N Mirzabeigi\",\"doi\":\"10.1097/PRS.0000000000012156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The purpose of this study was to review the safety and efficacy of delayed prepectoral deep inferior epigastric perforator (DIEP) flap augmentation in both primary DIEP flap augmentation and revision DIEP flap augmentation (ie, prepectoral conversion).</p><p><strong>Methods: </strong>A retrospective review of records was performed on all patients who underwent primary and revision breast reconstruction from August of 2018 to August of 2024 performed by a single surgeon.</p><p><strong>Results: </strong>A total of 585 abdominally based free flaps were performed by the author during the aforementioned 6-year period. Thirty-two of these autologous reconstructions (5.5%) proceeded to undergo prepectoral DIEP flap augmentation. Thirty-two primary DIEP flaps and 8 prepectoral conversions (subpectoral DIEP flap augmentation to prepectoral DIEP flap augmentation) were performed. There were no acute flap-related complications caused by implant placement. Two implants experienced inferior malposition prompting the adoption of TIGR matrix support later in the series. Following the adoption of a resorbable mesh for soft-tissue support, there were no further cases of inferior malposition.</p><p><strong>Conclusions: </strong>Delayed prepectoral DIEP flap augmentation is a safe and effective means of hybrid breast reconstruction. Inferior soft-tissue support should be strongly considered, particularly with use of smooth implants, in this setting.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>\",\"PeriodicalId\":20128,\"journal\":{\"name\":\"Plastic and reconstructive surgery\",\"volume\":\" \",\"pages\":\"444e-450e\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Plastic and reconstructive surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PRS.0000000000012156\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic and reconstructive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PRS.0000000000012156","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/21 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Prepectoral Implant Placement with Pedicle Division and Resorbable Mesh Reinforcement for DIEP Flap Augmentation.
Background: The purpose of this study was to review the safety and efficacy of delayed prepectoral deep inferior epigastric perforator (DIEP) flap augmentation in both primary DIEP flap augmentation and revision DIEP flap augmentation (ie, prepectoral conversion).
Methods: A retrospective review of records was performed on all patients who underwent primary and revision breast reconstruction from August of 2018 to August of 2024 performed by a single surgeon.
Results: A total of 585 abdominally based free flaps were performed by the author during the aforementioned 6-year period. Thirty-two of these autologous reconstructions (5.5%) proceeded to undergo prepectoral DIEP flap augmentation. Thirty-two primary DIEP flaps and 8 prepectoral conversions (subpectoral DIEP flap augmentation to prepectoral DIEP flap augmentation) were performed. There were no acute flap-related complications caused by implant placement. Two implants experienced inferior malposition prompting the adoption of TIGR matrix support later in the series. Following the adoption of a resorbable mesh for soft-tissue support, there were no further cases of inferior malposition.
Conclusions: Delayed prepectoral DIEP flap augmentation is a safe and effective means of hybrid breast reconstruction. Inferior soft-tissue support should be strongly considered, particularly with use of smooth implants, in this setting.
Clinical question/level of evidence: Therapeutic, IV.
期刊介绍：
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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