Changes in the Microcirculation and Physiologic Perfusion Dynamics of Free DIEP Flaps in the First 72 h After Breast Reconstruction

被引:0
作者
Ehrl, Denis [1 ,2 ]
Alt, Verena [2 ]
Taha, Sara [2 ]
Frank, Konstantin [3 ]
Wachtel, Nikolaus [2 ]
Bodenschatz, Karl J. [4 ]
Demmer, Wolfram [2 ]
Fuchs, Benedikt [2 ]
Giunta, Riccardo E. [2 ]
Moellhoff, Nicholas [2 ]
机构
[1] Paracelsus Med Univ, Nuremberg Hosp, Burn Ctr Severe Burn Injuries, Dept Plast Reconstruct & Hand Surg, Breslauer Str 201,90471 Nuremberg Prof Ernst Natha, D-90419 Nurnberg, Germany
[2] Ludwig Maximilians Univ Munchen, Univ Hosp, Div Hand Plast & Aesthet Surg, D-81377 Munich, Germany
[3] Univ Hosp Regensburg, Dept Plast Hand & Reconstruct Surg, D-93053 Regensburg, Germany
[4] Paracelsus Med Univ, Nuremberg Gen Hosp, Dept Pediat Surg & Urol, D-90419 Nurnberg, Germany
关键词
breast reconstruction; microsurgery; autologous reconstruction; breast cancer; LASER-DOPPLER FLOWMETRY; QUALITY-OF-LIFE; BLOOD-FLOW; EXPERIENCE; SALVAGE; SKIN;
D O I
10.3390/jcm14020520
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Objectives: The autologous reconstruction of the female breast using a microsurgical DIEP flap is a reliable and safe method. To detect impairments early and preserve the microvascular flap through timely revision, a better understanding of physiologic perfusion dynamics is necessary. This exploratory study examines changes in microcirculation in free DIEP flaps within the first 72 h after vascular anastomosis using laser Doppler flowmetry and white-light spectrophotometry. Methods: This single-center study analyzed retro- and prospectively collected data from female patients who underwent uneventful breast reconstruction using a DIEP flap and were monitored using the O2C device (LEA Medizintechnik, Giessen, Germany). Microcirculation was monitored continuously postoperatively for a period of 72 h. Results: A total of 36 patients with a mean age of 48.86 (9.36) years and a mean BMI of 26.78 (4.12) kg/m2 received 40 DIEP flaps (four bilateral reconstructions). Microcirculatory blood flow showed a continuous increase, reaching up to 15% above its initial value within the first 72 h following anastomosis. The average tissue oxygen saturation (sO2) and relative hemoglobin (rHB) levels remained fairly stable throughout the study period, with overall reductions of 5.46% and 5.30%, respectively. Conclusions: Autologous breast reconstruction using a microvascular DIEP flap is a safe and reliable technique. This study showed an increase in blood flow over the 72 h study period. At the same time, sO2 and rHb showed stable levels. Deviations in these values could be interpreted as indicators of a perfusion disorder of the microvascular flap.
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页数:12
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