Annalisa Cogliandro, Riccardo De Bernardis, Giovanni Calabrese, Rosa Salzillo, Valeria Petrucci, Barbara Cagli, Stefania Tenna, Marco Gratteri, Giovanni Francesco Marangi, Paolo Persichetti
{"title":"背阔肌皮瓣与肌皮背阔肌皮瓣在延迟乳房重建术中的对比研究。","authors":"Annalisa Cogliandro, Riccardo De Bernardis, Giovanni Calabrese, Rosa Salzillo, Valeria Petrucci, Barbara Cagli, Stefania Tenna, Marco Gratteri, Giovanni Francesco Marangi, Paolo Persichetti","doi":"10.1007/s00266-025-05042-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The latissimus dorsi (LD) flap, either muscular or myo-cutaneous, is an effective autologous option for breast reconstruction in cases of poor local tissue quality. The technique is reliable, with low complication rates and good patient acceptance. The surgical incision site impacts postoperative outcomes in terms of aesthetics, psychosocial well-being, physical comfort, scar perception, and sensory changes, assessable through Patient-Reported Outcome Measures (PROMs).</p><p><strong>Materials and methods: </strong>We conducted a cross sectional study on patients who underwent delayed monolateral LD flap breast reconstruction after mastectomy between 2018 and 2022.</p><p><strong>Inclusion criteria: </strong>(1) delayed LD flap reconstruction; (2) ≥ 2 years of follow-up; (3) standardized pre- and postoperative photo documentation; (4) proficiency in Italian language; (5) signed informed consent. All procedures were performed by the same surgical team. Patients completed BREAST-Q and SCAR-Q modules at least one year postoperatively.</p><p><strong>Results: </strong>Thirty-one patients were included: 16 with myo-cutaneous LD flaps (Group 1) and 15 with Z-scar muscular LD flaps (Group 2). Group 2 reported significantly better SCAR-Q scores in \"Appearance\" (p = 0.001), \"Symptoms\" (p = 0.021), and \"Psychosocial Impact\" (p = 0.019). In the BREAST-Q LD module, \"Satisfaction with back\" was higher in Group 2 (p = 0.016), while \"Physical well-being: back and shoulder\" was similar (p = 0.998).</p><p><strong>Conclusions: </strong>Both techniques achieved high patient satisfaction, but the muscular LD flap showed significantly better donor site scar satisfaction. Larger studies with longer follow-up and bigger sample size are needed to confirm these findings and optimize surgical decision-making.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Muscular Versus Myo-cutaneous Latissimus Dorsi Flap in Delayed Breast Reconstruction: A Comparative Study of Postoperative Outcomes.\",\"authors\":\"Annalisa Cogliandro, Riccardo De Bernardis, Giovanni Calabrese, Rosa Salzillo, Valeria Petrucci, Barbara Cagli, Stefania Tenna, Marco Gratteri, Giovanni Francesco Marangi, Paolo Persichetti\",\"doi\":\"10.1007/s00266-025-05042-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The latissimus dorsi (LD) flap, either muscular or myo-cutaneous, is an effective autologous option for breast reconstruction in cases of poor local tissue quality. The technique is reliable, with low complication rates and good patient acceptance. The surgical incision site impacts postoperative outcomes in terms of aesthetics, psychosocial well-being, physical comfort, scar perception, and sensory changes, assessable through Patient-Reported Outcome Measures (PROMs).</p><p><strong>Materials and methods: </strong>We conducted a cross sectional study on patients who underwent delayed monolateral LD flap breast reconstruction after mastectomy between 2018 and 2022.</p><p><strong>Inclusion criteria: </strong>(1) delayed LD flap reconstruction; (2) ≥ 2 years of follow-up; (3) standardized pre- and postoperative photo documentation; (4) proficiency in Italian language; (5) signed informed consent. All procedures were performed by the same surgical team. Patients completed BREAST-Q and SCAR-Q modules at least one year postoperatively.</p><p><strong>Results: </strong>Thirty-one patients were included: 16 with myo-cutaneous LD flaps (Group 1) and 15 with Z-scar muscular LD flaps (Group 2). Group 2 reported significantly better SCAR-Q scores in \\\"Appearance\\\" (p = 0.001), \\\"Symptoms\\\" (p = 0.021), and \\\"Psychosocial Impact\\\" (p = 0.019). In the BREAST-Q LD module, \\\"Satisfaction with back\\\" was higher in Group 2 (p = 0.016), while \\\"Physical well-being: back and shoulder\\\" was similar (p = 0.998).</p><p><strong>Conclusions: </strong>Both techniques achieved high patient satisfaction, but the muscular LD flap showed significantly better donor site scar satisfaction. Larger studies with longer follow-up and bigger sample size are needed to confirm these findings and optimize surgical decision-making.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. 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Muscular Versus Myo-cutaneous Latissimus Dorsi Flap in Delayed Breast Reconstruction: A Comparative Study of Postoperative Outcomes.
Introduction: The latissimus dorsi (LD) flap, either muscular or myo-cutaneous, is an effective autologous option for breast reconstruction in cases of poor local tissue quality. The technique is reliable, with low complication rates and good patient acceptance. The surgical incision site impacts postoperative outcomes in terms of aesthetics, psychosocial well-being, physical comfort, scar perception, and sensory changes, assessable through Patient-Reported Outcome Measures (PROMs).
Materials and methods: We conducted a cross sectional study on patients who underwent delayed monolateral LD flap breast reconstruction after mastectomy between 2018 and 2022.
Inclusion criteria: (1) delayed LD flap reconstruction; (2) ≥ 2 years of follow-up; (3) standardized pre- and postoperative photo documentation; (4) proficiency in Italian language; (5) signed informed consent. All procedures were performed by the same surgical team. Patients completed BREAST-Q and SCAR-Q modules at least one year postoperatively.
Results: Thirty-one patients were included: 16 with myo-cutaneous LD flaps (Group 1) and 15 with Z-scar muscular LD flaps (Group 2). Group 2 reported significantly better SCAR-Q scores in "Appearance" (p = 0.001), "Symptoms" (p = 0.021), and "Psychosocial Impact" (p = 0.019). In the BREAST-Q LD module, "Satisfaction with back" was higher in Group 2 (p = 0.016), while "Physical well-being: back and shoulder" was similar (p = 0.998).
Conclusions: Both techniques achieved high patient satisfaction, but the muscular LD flap showed significantly better donor site scar satisfaction. Larger studies with longer follow-up and bigger sample size are needed to confirm these findings and optimize surgical decision-making.
Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
期刊介绍：
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.
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