TY - JOUR
T1 - Abdominal donor-site complications following autologous breast reconstruction
T2 - A multi-institutional multisurgeon study
AU - Fisher, Marlie H.
AU - Ohmes, Lucas B.
AU - Yang, Jerry H.
AU - Le, Elliot
AU - Colakoglu, Salih
AU - French, Mackenzie
AU - Siddikoglu, Duygu
AU - Um, Grace
AU - Winocour, Julian
AU - Higdon, Kent
AU - Perdikis, Galen
AU - Inchauste, Suzanne
AU - Cohen, Justin
AU - Chong, Tae
AU - Kaoutzanis, Christodoulos
AU - Mathes, David W.
N1 - Publisher Copyright:
© 2024
PY - 2024/3
Y1 - 2024/3
N2 - Background: The deep inferior epigastric perforator (DIEP) free flap is the gold standard procedure for autologous breast reconstruction. Although breast-related complications have been well described, donor-site complications and contributing patient risk factors are poorly understood. Methods: We examined a multi-institutional, prospectively maintained database of patients undergoing DIEP free flap breast reconstruction between 2015 and 2020. We evaluated patient demographics, operative details, and abdominal donor-site complications. Logistic regression modeling was used to predict donor-site outcomes based on patient characteristics. Results: A total of 661 patients were identified who underwent DIEP free flap breast reconstruction across multiple institutions. Using logistic regression modeling, we found that body mass index (BMI) was an independent risk factor for umbilical complications (odds ratio [OR] 1.11, confidence interval [CI] 1.04–1.18, p = 0.001), seroma (OR 1.07, CI 1.01–1.13, p = 0.003), wound dehiscence (OR 1.10, CI 1.06–1.15, p = 0.001), and surgical site infection (OR 1.10, CI 1.05–1.15, p = 0.001) following DIEP free flap breast reconstruction. Further, immediate reconstruction decreases the risk of abdominal bulge formation (OR 0.22, CI 0.108–0.429, p = 0.001). Perforator selection was not associated with abdominal morbidity in our study population. Conclusions: Higher BMI is associated with increased abdominal donor-site complications following DIEP free flap breast reconstruction. Efforts to lower preoperative BMI may help decrease donor-site complications.
AB - Background: The deep inferior epigastric perforator (DIEP) free flap is the gold standard procedure for autologous breast reconstruction. Although breast-related complications have been well described, donor-site complications and contributing patient risk factors are poorly understood. Methods: We examined a multi-institutional, prospectively maintained database of patients undergoing DIEP free flap breast reconstruction between 2015 and 2020. We evaluated patient demographics, operative details, and abdominal donor-site complications. Logistic regression modeling was used to predict donor-site outcomes based on patient characteristics. Results: A total of 661 patients were identified who underwent DIEP free flap breast reconstruction across multiple institutions. Using logistic regression modeling, we found that body mass index (BMI) was an independent risk factor for umbilical complications (odds ratio [OR] 1.11, confidence interval [CI] 1.04–1.18, p = 0.001), seroma (OR 1.07, CI 1.01–1.13, p = 0.003), wound dehiscence (OR 1.10, CI 1.06–1.15, p = 0.001), and surgical site infection (OR 1.10, CI 1.05–1.15, p = 0.001) following DIEP free flap breast reconstruction. Further, immediate reconstruction decreases the risk of abdominal bulge formation (OR 0.22, CI 0.108–0.429, p = 0.001). Perforator selection was not associated with abdominal morbidity in our study population. Conclusions: Higher BMI is associated with increased abdominal donor-site complications following DIEP free flap breast reconstruction. Efforts to lower preoperative BMI may help decrease donor-site complications.
KW - Abdominal wall
KW - Breast reconstruction
KW - Bulge
KW - Complications
KW - Deep inferior epigastric perforator flap
KW - Donor site
KW - Hernia
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U2 - 10.1016/j.bjps.2024.01.033
DO - 10.1016/j.bjps.2024.01.033
M3 - Article
C2 - 38364673
AN - SCOPUS:85186117189
SN - 1748-6815
VL - 90
SP - 88
EP - 94
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
ER -