Breast Cancer
Conditions
Keywords
breast reconstruction, DIEP flap, Nerve coaptation, Sensory recovery
Brief summary
The sensory recovery of the breast remains an undervalued aspect of breast reconstruction and surgical reinnervation is not regarded as a priority by most reconstructive surgeons. A prospective study was conducted of all patients who underwent either innervated or non-innervated DIEP flap breast reconstruction in Maastricht University Medical Center and returned for follow-up between September 2015 and July 2017. Semmes-Weinstein monofilaments were used for sensory testing of the breast. This study showed that nerve coaptation in DIEP flap breast reconstruction resulted in a significantly improved sensation of the reconstructed breast compared to non-innervated flaps.
Interventions
PROCEDURESensory nerve coaptation
A recipient sensory nerve of the abdomen was reattached to a donor nerve in the chest area. The sensory branch of usually the 11th intercostal nerve was used as recipient nerve for nerve coaptation and the anterior cutaneous branch of the third intercostal nerve was used as donor nerve. Direct, end-to-end nerve coaptation was performed with two stitches.
Sponsors
Maastricht University Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female patients 18 years or older * Unilateral or bilateral DIEP flap breast reconstruction * Returned for follow-up between September 2015 and July 2017 * Informed consent
Exclusion criteria
* Bilateral breast reconstruction with a unilateral innervated DIEP flap and a contralateral non-innervated flap * Flaps that required a take-back
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The extent of sensory recovery of the reconstructed breast to touch | Through study completion up to 24 months postoperatively | The sensory recovery of the breast to touch was tested at different follow-up moments after the initial surgery. Semmes-Weinstein monofilaments were used for sensory testing. Nine areas of the breast, indicating native skin and flap skin, were tested. Mean monofilament values were calculated for each area and compared between groups. |
Countries
Netherlands
Outcome results
None listed