Flap Failure and Wound Complications in Autologous Breast Reconstruction: A National Perspective

• Published in: Aesthetic plastic surgery 2015-12, Vol.39 (6), p.902-909
• Main Authors: Massenburg, Benjamin B., Sanati-Mehrizy, Paymon, Ingargiola, Michael J., Rosa, Jonatan Hernandez, Taub, Peter J.
• Format: Article
• Language: English
• Subjects: Female; Free Tissue Flaps; Humans; Mammaplasty - adverse effects; Mammaplasty - methods; Medicine; Medicine & Public Health; Middle Aged; Original Article; Otorhinolaryngology; Plastic Surgery; Retrospective Studies; Risk Factors; Surgical Wound Dehiscence - etiology; Surgical Wound Infection - etiology; Treatment Failure
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-015-0575-8

Purpose There are many options for breast reconstruction following a mastectomy, and data on outcomes are greatly needed for both the patient and the care provider. This study aims to identify the prevalence and predictors of adverse outcomes in autologous breast reconstruction in order to better inform patients and surgeons when choosing a surgical technique. Methods This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified each autologous breast reconstruction performed between 2005 and 2012. Of the 6855 autologous breast reconstructions, there were 2085 latissimus dorsi (LD) flap procedures, 2464 pedicled transverse rectus abdominis myocutaneous (TRAM) flap procedures, and 2306 free flap procedures that met the inclusion criteria. The prevalence of complications in each of the three procedures was calculated and compared using χ 2 analysis for binomial categorical variables. Univariate and multivariate logistic regression analyses identified independent risk factors for adverse outcomes in autologous reconstruction as a whole. Results The prevalence of general complications was 10.8 % in LD flaps, 20.6 % in TRAM flaps, and 26.1 % in free flaps for autologous breast reconstruction ( p