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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Yim, Ji Hong (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) Yun, Jiyoung (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) Lee, Taik Jong (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) Kim, Eun Key (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) Cho, Jonghan (Seoul Plastic Surgery Clinic) Eom, Jin Sup (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
저널정보
대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제42권 제6호
발행연도
2015.1
수록면
741 - 745 (5page)

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Background Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period. Methods A retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed. Results During the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation. Conclusions The salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.
#Perforator flap #Surgical flaps #Free tissue flaps #Salvage therapy #Breast

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참고문헌 (18)

참고문헌 신청
Selber JC / 2012 / The survival curve: factors impacting the outcome of free flap take-backs / Plast Reconstr Surg 130:105~113 google schola Chen KT / 2007 / Timing of presentation of the first signs of vascular compromise dictates the salvage outcome of free flap transfers / Plast Reconstr Surg 120:187~195 google schola Mirzabeigi MN / 2012 / Free flap take-back following postoperative microvascular compromise : predicting salvage versus failure / Plast Reconstr Surg 130:579~589 google schola Koshima I / 1989 / Inferior epigastric artery skin flaps without rectus abdominis muscle / Br J Plast Surg 42:645~648 google schola Galanis C / 2014 / Microvascular lifeboats: a stepwise approach to intraoperative venous congestion in DIEP flap breast reconstruction / Plast Reconstr Surg 134:20~27 google schola

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