Mammaplasty, Microsurgery, Rip Reconstruction Cartilage
Conditions
Brief summary
Exposure of internal mammary vessels in autologous breast reconstruction often requires removal of a rib cartilage segment, which can lead to contour deformity in the craniomedial breast pole. This study evaluated the use of diced cartilage (DC) to counteract substance loss in the microvascular anastomosis area, and investigated safety and suitability of the procedure to avoid postoperative deformities.
Detailed description
This retrospective, single-center cohort study included all breast reconstructions in which DC was used from October 2021 to June 2023. Reconstructions using DC were subdivided based on previous exposure to breast radiotherapy (DC vs. DCR). The control group consisted of an equal number of consecutive reconstructions performed prior to the use of DC. The effect of DC on breast contour preservation was investigated using breast magnetic resonance imaging (MRI; \> 6 months post-op) and photographic documentation (6-month follow-up).
Interventions
PROCEDUREdiced cartilage
In reconstructions using DC management of IMVES, the surgical nurse processed the removed cartilage into DC using a dermatome blade. Cartilage pieces of approximately 0,5-1 mm were used. After microvascular anastomosis (coupler device for venous anastomosis; Synovis MCA, Birmingham AL, USA), all DC was placed back into the rib removal zone using a blunt dissector. The vessels were embedded and stabilized in cartilage paste according to the desired orientation.
Sponsors
Breast Imaging Division, Radiologie Augsburg Friedberg / Breast Center Augsburg, Augsburg, Germany
ISAR Klinikum
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 99 Years
Healthy volunteers
Yes
Inclusion criteria
* Autologous free flap breast reconstruction using the internal mammary vessels as recipient vessels from October 2021 to June 2023 * MRI subcohort: Magnetic resonance imaging (MRI) scans performed at least 6 months postoperatively
Exclusion criteria
* Autologous free flap breast reconstruction using a perforator of the internal mammary vessels as recipient vessels from October 2021 to June 2023 * Autologous free flap breast reconstruction using the thoracodorsal vessels as recipient vessels from October 2021 to June 2023
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Magnetic resonance imaging (MRI) scans: soft tissue sinking of the recipient vessels area | October 2021 to June 2023 | the sinking depth of epicostal soft tissue into the space of rib segment resection on axial planes in Magnetic resonance imaging (MRI) scans performed at least 6 months postoperatively |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual contour deficit of the recipient vessels area | October 2021 to June 2023 | Postoperative photographic images were examined by two investigators (blinded to group assignments) for IMVES-associated deformities using standardized photographic images of the reconstructed breasts at the 6-month follow-up. |
Countries
Germany
Outcome results
None listed