Breast Cancer
Conditions
Keywords
Breast reconstruction, DIEP flap, Sensory recovery, Breast sensation, Nerve coaptation
Brief summary
Restoring the sensation of the breast becomes increasingly recognized as a critical part of autologous breast reconstruction. A prospective study was conducted of all patients who underwent either innervated or non-innervated deep inferior epigastric perforator (DIEP) flap breast reconstruction in Maastricht University Medical Center between August 2016 and August 2018 and who returned between for a follow-up visit between the start of the study and August 2019. Semmes-Weinstein monofilaments were used for sensory testing of the breast.
Interventions
PROCEDURESensory nerve coaptation
A recipient sensory nerve branch of the 11th-12th intercostal nerve was reattached to a donor nerve in the chest area. The anterior cutaneous branch of the second or third intercostal nerve was used as the donor nerve. Direct, end-to-end nerve coaptation was performed.
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 August 2016 and August 2019 * Informed consent
Exclusion criteria
* Total flap loss complication * Flaps that required a take-back * Follow-up less than six months postoperatively * Only one postoperative measurement at less than 12 months follow-up * Mixed reconstructions: an innervated breast reconstruction on one side and a noninnervated breast reconstruction on the other side
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean monofilament value as a measure for the sensory recovery of the reconstructed breast | Through study completion up to 36 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean monofilament value as a measure for the sensory recovery of the reconstructed breast | Through study completion up to 36 months postoperatively | The sensory recovery of the donor site to touch was tested at different follow-up moments after the initial surgery. Semmes-Weinstein monofilaments were used for sensory testing. Four areas of the donor site were tested, two areas above and two areas below the scar. Mean monofilament values were calculated for the total donor site and compared between groups. |
Countries
Netherlands
Outcome results
None listed