Abdominal donor-site complications following autologous breast reconstruction: A multi-institutional multisurgeon study

Marlie H. Fisher, Lucas B. Ohmes, Jerry H. Yang, Elliot Le, Salih Colakoglu, Mackenzie French, Duygu Siddikoglu, Grace Um, Julian Winocour, Kent Higdon, Galen Perdikis, Suzanne Inchauste, Justin Cohen, Tae Chong, Christodoulos Kaoutzanis, David W. Mathes

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)88-94
Number of pages7
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume90
DOIs
StatePublished - Mar 2024

Keywords

  • Abdominal wall
  • Breast reconstruction
  • Bulge
  • Complications
  • Deep inferior epigastric perforator flap
  • Donor site
  • Hernia

ASJC Scopus subject areas

  • Surgery

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