Improved safety of autologous breast reconstruction surgery by stabilisation of microsurgical vessel anastomoses using fibrin sealant in 349 free DIEP or fascia-muscle-sparing (fms)-TRAM flaps: A two-centre study

Abstract Background We routinely perform free DIEP flap and fascia-muscle-sparing (fms) TRAM flap procedures using fibrin sealant to stabilise anastomosed vessels, thus avoiding some of the difficulties associated with microsurgical anastomoses. Methods Women undergoing elective, autologous breast r...

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Bibliographic Details
Published in:Breast (Edinburgh) 2008-10, Vol.17 (5), p.492-498
Main Authors: Andree, Christoph, Munder, Beatrix I.J, Behrendt, Philipp, Hellmann, Simone, Audretsch, Werner, Voigt, Matthias, Reis, Christoph, Beckmann, Matthias W, Horch, Raymund E, Bach, Alexander D
Format: Article
Language:English
Subjects:
Adult
Aged
Anastomosis
Anastomosis, Surgical
Breast reconstruction
DIEP
Epigastric Arteries - surgery
Female
Fibrin sealant
Fibrin Tissue Adhesive
Follow-Up Studies
Hematology, Oncology and Palliative Medicine
Humans
Mammaplasty - adverse effects
Mammaplasty - methods
Microsurgery - adverse effects
Microsurgery - methods
Middle Aged
Rectus Abdominis - blood supply
Rectus Abdominis - surgery
Retrospective Studies
Stabilisation
Surgical Flaps
TRAM
Treatment Outcome
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Summary:Abstract Background We routinely perform free DIEP flap and fascia-muscle-sparing (fms) TRAM flap procedures using fibrin sealant to stabilise anastomosed vessels, thus avoiding some of the difficulties associated with microsurgical anastomoses. Methods Women undergoing elective, autologous breast reconstruction with free DIEP flaps or fms-TRAM flaps between June 2004 and June 2007 in two Interdisciplinary Breast Centres were included in a retrospective chart review. Results A total of 349 breast reconstructions were performed in 325 women. Of these, 201 (57.6%) were free DIEP flap procedures and 148 (42.4%) were fms-TRAM flap procedures. Average hospital stay was 9.8 days. Complete flap loss was seen in 3 cases (0.9%). Low rates of post-operative complications were observed. Conclusions Microsurgical breast reconstruction using free DIEP flaps and fms-TRAM flaps, with fibrin sealant for stabilisation of microvascular anastomoses, provides good post-operative outcome featuring a low incidence of flap loss or other common post-operative complications.
ISSN:0960-9776
1532-3080
DOI:10.1016/j.breast.2008.03.010