Breast Reconstruction with Free Tissue Transfer from the Abdomen in the Morbidly Obese
Breast Reconstruction with Free Tissue Transfer from the Abdomen in the Morbidly Obese
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DOI：
10.1097/prs.0b013e3182131c93
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发表时间：
2011-06-01
影响因子：
3.6
通讯作者：
Serletti, Joseph M.
中科院分区：
文献类型：
--
作者：
Jandali, Shareef;Nelson, Jonas A.;Serletti, Joseph M.
背景资料：病态肥胖症和利用腹部游离组织移植进行自体乳房再造的发病率呈全国性上升趋势。本研究的目的是评估在病态肥胖population.Methods的安全性和有效性的游离皮瓣乳房重建：回顾性分析所有患者进行了横向腹直肌肌皮，深腹壁下动脉穿支，或浅腹壁下动脉皮瓣乳房重建2006年7月至2008年10月。将所有体重指数大于40的患者的数据与体重指数小于40的患者的数据进行比较。p值小于0.05被认为是显著的。显着的调查结果，然后分析了在一个事后的时尚，以检查趋势增加身体质量index.Results：四百四例患者进行了612游离皮瓣乳房重建在研究期间。其中25名患者（6%）的体重指数大于40。病态肥胖组的总皮瓣丢失率（p = 0.02），总的主要术后并发症（p = 0.05）和伤口愈合延迟（p = 0.006）显著较高。结论：病态肥胖患者的游离皮瓣乳房再造与总皮瓣丢失，总的主要术后并发症和腹部伤口愈合延迟的风险较高相关。然而，并发症的总体发生率较低，使得从腹部游离组织转移成为该患者人群中可接受的乳房重建方法。（Plast。重建127：2206，2011）。
Background: There are national trends of increasing incidence of morbid obesity and autologous breast reconstruction with free tissue transfer from the abdomen. The purpose of this study was to assess the safety and efficacy of free flap breast reconstruction in the morbidly obese population.Methods: A retrospective review was conducted on all patients who underwent transverse rectus abdominis myocutaneous, deep inferior epigastric perforator, or superficial inferior epigastric artery flap breast reconstructions between July of 2006 and October of 2008. Data from all patients with a body mass index greater than 40 were compared with those of patients with a body mass index less than 40. A p value less than 0.05 was considered significant. Significant findings were then analyzed in a post hoc fashion to examine trends with increasing body mass index.Results: Four hundred four patients underwent 612 free flap breast reconstructions during the study period. Twenty-five of these patients (6 percent) had a body mass index greater than 40. The morbidly obese group had significantly higher rate of total flap loss (p = 0.02), total major postoperative complications (p = 0.05), and delayed wound healing (p = 0.006).Conclusions: Free flap breast reconstruction in the morbidly obese is associated with a higher risk of total flap loss, total major postoperative complications, and delayed abdominal wound healing. However, the overall incidence of complications is low, making free tissue transfer from the abdomen an acceptable method of breast reconstruction in this patient population. (Plast. Reconstr. Surg. 127: 2206, 2011.)