Safety of salvaging impending flap congestion in breast reconstruction by venous supercharging of the cephalic vein.
Identifieur interne : 005A19 ( Ncbi/Checkpoint ); précédent : 005A18; suivant : 005A20Safety of salvaging impending flap congestion in breast reconstruction by venous supercharging of the cephalic vein.
Auteurs : Luis Landin [Espagne] ; Pedro Bolado ; Cesar Casado-Sanchez ; Jorge Bonastre ; Marta Garcia-Redondo ; Shirin Zharbakhsh ; Jesus Diez ; Francisco Leyva ; Cesar Casado-PerezSource :
- Annals of plastic surgery [ 1536-3708 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Bras (), Cicatrice (), Cicatrice (étiologie), Complications postopératoires (), Femelle, Humains, Hyperhémie (), Hyperhémie (étiologie), Lambeaux chirurgicaux (), Lymphoedème (), Lymphoedème (étiologie), Mammoplastie (), Résultat thérapeutique, Sujet âgé, Survie du greffon, Thérapie de rattrapage (), Veines (transplantation), Études de suivi, Études prospectives.
- MESH :
- étiologie : Cicatrice, Hyperhémie, Lymphoedème, Veines.
- Adulte d'âge moyen, Bras, Cicatrice, Complications postopératoires, Femelle, Humains, Hyperhémie, Lambeaux chirurgicaux, Lymphoedème, Mammoplastie, Résultat thérapeutique, Sujet âgé, Survie du greffon, Thérapie de rattrapage, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Aged, Arm (blood supply), Cicatrix (etiology), Cicatrix (prevention & control), Female, Follow-Up Studies, Graft Survival, Humans, Hyperemia (etiology), Hyperemia (surgery), Lymphedema (etiology), Lymphedema (prevention & control), Mammaplasty (methods), Middle Aged, Postoperative Complications (prevention & control), Postoperative Complications (surgery), Prospective Studies, Salvage Therapy (methods), Surgical Flaps (blood supply), Surgical Flaps (surgery), Treatment Outcome, Veins (transplantation).
- MESH :
- blood supply : Arm, Surgical Flaps.
- etiology : Cicatrix, Hyperemia, Lymphedema.
- methods : Mammaplasty, Salvage Therapy.
- prevention & control : Cicatrix, Lymphedema, Postoperative Complications.
- surgery : Hyperemia, Postoperative Complications, Surgical Flaps.
- transplantation : Veins.
- Aged, Female, Follow-Up Studies, Graft Survival, Humans, Middle Aged, Prospective Studies, Treatment Outcome.
Abstract
Autologous flap breast reconstruction is an established technique that carries a risk of vascular failure. We evaluated the safety of salvaging impending venous congestion by using the cephalic vein for supercharging autologous abdominal flaps. Our main outcome measures were flap survival, triggering or impairing lymphedema as measured by the physician or reported by the patient, and scar severity as measured by the Vancouver scar scale. We were able to save 100% of the flaps, but could not find any statistical association with or without increased lymphedema before and after the procedure. One patient reported that lymphedema worsened. The patients accepted the scars (mean Vancouver scar scale score, 5.7). In sum, using the cephalic vein to improve venous drainage of autologous breast reconstruction was safe and did not trigger or impair lymphedema, but scarring in the upper arm was unavoidable.
DOI: 10.1097/SAP.0b013e31828d9983
PubMed: 23759974
Affiliations:
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<wicri:regionArea>From the *Division of Plastic and Reconstructive Surgery and †Biostatistics Section, Hospital Universitario La Paz; and ‡Division of Plastic and Reconstructive Surgery, Hospital Clínico Universitario, Madrid</wicri:regionArea>
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<author><name sortKey="Zharbakhsh, Shirin" sort="Zharbakhsh, Shirin" uniqKey="Zharbakhsh S" first="Shirin" last="Zharbakhsh">Shirin Zharbakhsh</name>
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<author><name sortKey="Diez, Jesus" sort="Diez, Jesus" uniqKey="Diez J" first="Jesus" last="Diez">Jesus Diez</name>
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<author><name sortKey="Leyva, Francisco" sort="Leyva, Francisco" uniqKey="Leyva F" first="Francisco" last="Leyva">Francisco Leyva</name>
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<term>Arm (blood supply)</term>
<term>Cicatrix (etiology)</term>
<term>Cicatrix (prevention & control)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Graft Survival</term>
<term>Humans</term>
<term>Hyperemia (etiology)</term>
<term>Hyperemia (surgery)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (prevention & control)</term>
<term>Mammaplasty (methods)</term>
<term>Middle Aged</term>
<term>Postoperative Complications (prevention & control)</term>
<term>Postoperative Complications (surgery)</term>
<term>Prospective Studies</term>
<term>Salvage Therapy (methods)</term>
<term>Surgical Flaps (blood supply)</term>
<term>Surgical Flaps (surgery)</term>
<term>Treatment Outcome</term>
<term>Veins (transplantation)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Bras ()</term>
<term>Cicatrice ()</term>
<term>Cicatrice (étiologie)</term>
<term>Complications postopératoires ()</term>
<term>Femelle</term>
<term>Humains</term>
<term>Hyperhémie ()</term>
<term>Hyperhémie (étiologie)</term>
<term>Lambeaux chirurgicaux ()</term>
<term>Lymphoedème ()</term>
<term>Lymphoedème (étiologie)</term>
<term>Mammoplastie ()</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Survie du greffon</term>
<term>Thérapie de rattrapage ()</term>
<term>Veines (transplantation)</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
</keywords>
<keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Arm</term>
<term>Surgical Flaps</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cicatrix</term>
<term>Hyperemia</term>
<term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Mammaplasty</term>
<term>Salvage Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Cicatrix</term>
<term>Lymphedema</term>
<term>Postoperative Complications</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Hyperemia</term>
<term>Postoperative Complications</term>
<term>Surgical Flaps</term>
</keywords>
<keywords scheme="MESH" qualifier="transplantation" xml:lang="en"><term>Veins</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Cicatrice</term>
<term>Hyperhémie</term>
<term>Lymphoedème</term>
<term>Veines</term>
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<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Graft Survival</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Prospective Studies</term>
<term>Treatment Outcome</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Bras</term>
<term>Cicatrice</term>
<term>Complications postopératoires</term>
<term>Femelle</term>
<term>Humains</term>
<term>Hyperhémie</term>
<term>Lambeaux chirurgicaux</term>
<term>Lymphoedème</term>
<term>Mammoplastie</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Survie du greffon</term>
<term>Thérapie de rattrapage</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
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<front><div type="abstract" xml:lang="en">Autologous flap breast reconstruction is an established technique that carries a risk of vascular failure. We evaluated the safety of salvaging impending venous congestion by using the cephalic vein for supercharging autologous abdominal flaps. Our main outcome measures were flap survival, triggering or impairing lymphedema as measured by the physician or reported by the patient, and scar severity as measured by the Vancouver scar scale. We were able to save 100% of the flaps, but could not find any statistical association with or without increased lymphedema before and after the procedure. One patient reported that lymphedema worsened. The patients accepted the scars (mean Vancouver scar scale score, 5.7). In sum, using the cephalic vein to improve venous drainage of autologous breast reconstruction was safe and did not trigger or impair lymphedema, but scarring in the upper arm was unavoidable.</div>
</front>
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<affiliations><list><country><li>Espagne</li>
</country>
<region><li>Communauté de Madrid</li>
</region>
<settlement><li>Madrid</li>
</settlement>
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<tree><noCountry><name sortKey="Bolado, Pedro" sort="Bolado, Pedro" uniqKey="Bolado P" first="Pedro" last="Bolado">Pedro Bolado</name>
<name sortKey="Bonastre, Jorge" sort="Bonastre, Jorge" uniqKey="Bonastre J" first="Jorge" last="Bonastre">Jorge Bonastre</name>
<name sortKey="Casado Perez, Cesar" sort="Casado Perez, Cesar" uniqKey="Casado Perez C" first="Cesar" last="Casado-Perez">Cesar Casado-Perez</name>
<name sortKey="Casado Sanchez, Cesar" sort="Casado Sanchez, Cesar" uniqKey="Casado Sanchez C" first="Cesar" last="Casado-Sanchez">Cesar Casado-Sanchez</name>
<name sortKey="Diez, Jesus" sort="Diez, Jesus" uniqKey="Diez J" first="Jesus" last="Diez">Jesus Diez</name>
<name sortKey="Garcia Redondo, Marta" sort="Garcia Redondo, Marta" uniqKey="Garcia Redondo M" first="Marta" last="Garcia-Redondo">Marta Garcia-Redondo</name>
<name sortKey="Leyva, Francisco" sort="Leyva, Francisco" uniqKey="Leyva F" first="Francisco" last="Leyva">Francisco Leyva</name>
<name sortKey="Zharbakhsh, Shirin" sort="Zharbakhsh, Shirin" uniqKey="Zharbakhsh S" first="Shirin" last="Zharbakhsh">Shirin Zharbakhsh</name>
</noCountry>
<country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Landin, Luis" sort="Landin, Luis" uniqKey="Landin L" first="Luis" last="Landin">Luis Landin</name>
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