Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation?
Background:. The goal of this study was to assess whether adding a latissimus dorsi (LD) flap to a secondary implant-based reconstruction (IBR) improves outcomes following explantation of the primary device due to infection. Methods:. We conducted a retrospective study of patients who underwent a se...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004409 |
| _version_ | 1818512898536767488 |
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| author | Cedar Slovacek, BS Malke Asaad, MD David Mitchell, BS Jesse C. Selber, MD, MPH, MHCM Mark W. Clemens, MD Carrie K. Chu, MD, MSCRs Alexander F. Mericli, MD Geoffrey L. Robb, MD Summer E. Hanson, MD, PhD Charles E. Butler, MD |
| author_facet | Cedar Slovacek, BS Malke Asaad, MD David Mitchell, BS Jesse C. Selber, MD, MPH, MHCM Mark W. Clemens, MD Carrie K. Chu, MD, MSCRs Alexander F. Mericli, MD Geoffrey L. Robb, MD Summer E. Hanson, MD, PhD Charles E. Butler, MD |
| author_sort | Cedar Slovacek, BS |
| collection | DOAJ |
| description | Background:. The goal of this study was to assess whether adding a latissimus dorsi (LD) flap to a secondary implant-based reconstruction (IBR) improves outcomes following explantation of the primary device due to infection.
Methods:. We conducted a retrospective study of patients who underwent a second IBR with or without the addition of an LD flap during 2006–2019, following explantation due to infection. Surgical outcomes were collected and compared between reconstruction types.
Results:. A total of 6093 IBRs were identified during the study period. Of these, 109 underwent a second attempt at breast reconstruction with IBR alone (n = 86, 79%) or IBR/LD (n = 23, 21%) following explantation of an infected device. Rates of secondary device explantation due to a complication were similar between the two groups (26% in the IBR/LD group and 21% in the IBR group; P = 0.60). Among the patients who underwent prior radiotherapy, the IBR/LD group had lower rates of any complication (38% versus 56%; P = 0.43), infection (25% versus 44%; P = 0.39), and reconstruction failure (25% versus 44%; P = 0.39); however, differences were not statistically significant.
Conclusion:. Following a failed primary breast reconstruction due to infection, it may be appropriate to offer a secondary reconstruction. For patients with a history of radiotherapy, combining an LD flap with IBR may provide benefits over IBR alone. Although not statistically different, this outcome may have clinical significance, considering the magnitude of the effect, and may result in decreased complication rates and a higher chance of reconstructive success. |
| first_indexed | 2024-12-10T23:53:26Z |
| format | Article |
| id | doaj.art-ca439071add0441d8a6bc58e893697bc |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-10T23:53:26Z |
| publishDate | 2022-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-ca439071add0441d8a6bc58e893697bc2022-12-22T01:28:41ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-08-01108e440910.1097/GOX.0000000000004409202208000-00027Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation?Cedar Slovacek, BS0Malke Asaad, MD1David Mitchell, BS2Jesse C. Selber, MD, MPH, MHCM3Mark W. Clemens, MD4Carrie K. Chu, MD, MSCRs5Alexander F. Mericli, MD6Geoffrey L. Robb, MD7Summer E. Hanson, MD, PhD8Charles E. Butler, MD9From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.From the Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.Background:. The goal of this study was to assess whether adding a latissimus dorsi (LD) flap to a secondary implant-based reconstruction (IBR) improves outcomes following explantation of the primary device due to infection. Methods:. We conducted a retrospective study of patients who underwent a second IBR with or without the addition of an LD flap during 2006–2019, following explantation due to infection. Surgical outcomes were collected and compared between reconstruction types. Results:. A total of 6093 IBRs were identified during the study period. Of these, 109 underwent a second attempt at breast reconstruction with IBR alone (n = 86, 79%) or IBR/LD (n = 23, 21%) following explantation of an infected device. Rates of secondary device explantation due to a complication were similar between the two groups (26% in the IBR/LD group and 21% in the IBR group; P = 0.60). Among the patients who underwent prior radiotherapy, the IBR/LD group had lower rates of any complication (38% versus 56%; P = 0.43), infection (25% versus 44%; P = 0.39), and reconstruction failure (25% versus 44%; P = 0.39); however, differences were not statistically significant. Conclusion:. Following a failed primary breast reconstruction due to infection, it may be appropriate to offer a secondary reconstruction. For patients with a history of radiotherapy, combining an LD flap with IBR may provide benefits over IBR alone. Although not statistically different, this outcome may have clinical significance, considering the magnitude of the effect, and may result in decreased complication rates and a higher chance of reconstructive success.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004409 |
| spellingShingle | Cedar Slovacek, BS Malke Asaad, MD David Mitchell, BS Jesse C. Selber, MD, MPH, MHCM Mark W. Clemens, MD Carrie K. Chu, MD, MSCRs Alexander F. Mericli, MD Geoffrey L. Robb, MD Summer E. Hanson, MD, PhD Charles E. Butler, MD Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation? Plastic and Reconstructive Surgery, Global Open |
| title | Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation? |
| title_full | Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation? |
| title_fullStr | Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation? |
| title_full_unstemmed | Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation? |
| title_short | Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation? |
| title_sort | does a latissimus dorsi flap improve surgical outcomes of implant based breast reconstruction following infected device explantation |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004409 |
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