Blood flow dynamics and sensitivity in breasts after reconstruction with DIEP-flap

被引:16
作者
Klasson, Stina [1 ]
Svensson, Karin [1 ]
Wollmer, Per [2 ,3 ]
Velander, Patrik [1 ]
Svensson, Henry [1 ]
机构
[1] Lund Univ, Skane Univ Hosp, Dept Plast & Reconstruct Surg, Malmo, Sweden
[2] Lund Univ, Skane Univ Hosp, Dept Clin Physiol, Malmo, Sweden
[3] Lund Univ, Skane Univ Hosp, Dept Clin Sci Malmo, Nucl Med Unit, Malmo, Sweden
关键词
Breast reconstruction; perforator; microvascular; plastic surgery; tumour; EPIGASTRIC PERFORATOR FLAP; SENSIBILITY;
D O I
10.3109/2000656X.2014.903194
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
A method of breast reconstruction is based on the Deep Inferior Epigastric Perforator (DIEP) technique. Skin and fat are transplanted from the abdomen to the chest; blood vessels are reconnected through microsurgery. Nerves are, however, left unconnected. This study aims to evaluate the blood flow and reinnervation of blood vessels and skin in breasts reconstructed by DIEP flaps without neural repair. In all, DIEP flaps of 10 patients were tested at an average of 16.3 months postoperatively. Blood flow was assessed by PeriScan PIM II System, both before and after indirect heating. Tactile perception threshold was assessed by Semmes-Weinstein monofilament and thermal sensibility by SENSELab MSA Thermotest. The patients' contralateral breasts were used as controls. The blood flow of the flaps was statistically significantly lower than in the control breasts, both before and after indirect heating. The change in blood flow after indirect heating did, however, not significantly differ when comparing the breasts. All flaps regained deep pressure sensibility in all four quadrants. Five patients regained even better sensibility in one of their quadrants. Seven patients regained perception of cold stimuli, five perceived warmth. This study has shown that skin blood flow regulation is present in DIEP flaps 1 year after reconstruction. Blood flow dynamics are very similar to those in the normal breast. There is also a recovery of tactile and thermal sensibility, but this study has not shown any clear parallels between recovery blood flow, tactile sensibility and thermal sensibility.
引用
收藏
页码:407 / 411
页数:5
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