Comparison of Ischemic Complications with Direct-to-Implant versus Immediate Free Flap Reconstruction After Nipple Sparing Mastectomy: A Propensity-Score Matched Analysis.
Comparison of Ischemic Complications with Direct-to-Implant versus Immediate Free Flap Reconstruction After Nipple Sparing Mastectomy: A Propensity-Score Matched Analysis.
- 2022
BACKGROUND: Both direct-to-implant (DTI) and immediate free flap (FF) breast reconstruction following nipple sparing mastectomy (NSM) have been described in the literature. However, there is a paucity of comparative studies between these two techniques. Furthermore, existing studies do not control for factors influencing ischemic complications. CONCLUSION: Both DTI and immediate FF reconstruction can be safely offered to patients undergoing NSM while providing the benefit of a single reconstructive procedure. Copyright 2022 by the American Society of Plastic Surgeons. METHODS: A retrospective review of all NSMs performed at a single institution between January 2014 and January 2020 was performed. Immediate FF reconstructions were propensity score matched using probit regression to identify a comparable DTI cohort based on mastectomy weight, smoking, age, and history of prior radiotherapy. Primary outcomes of interest were 30-day ischemic complications. RESULTS: 108 NSMs performed in 79 patients were included. Average age was 45.7 +/- 10.5 years old and mean BMI was 27.1 +/- 4.8 kg/m2. There were 54 breasts in both the DTI group and the immediate FF group. Median mastectomy weight in the DTI group was 508 (264 IQR) grams as compared to 473 (303 IQR) in the FF group [(p=0.792). There was no significant difference in the rate of partial nipple-areola complex (NAC) necrosis in the DTI and FF groups (5.6 percent versus 3.7 percent, respectively; p=0.500) or mastectomy flap necrosis (5.6 percent versus 11.1 percent; p= 0.297). Both the DTI and FF groups had a total NAC necrosis rate of 1.9 percent (p= 0.752).
English
0032-1052
00006534-990000000-01392 [pii] 10.1097/PRS.0000000000010094 [doi]
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
MedStar Georgetown University Hospital/MedStar Washington Hospital Center
Plastic Surgery Residency
Surgery/Plastic Surgery
Journal Article
BACKGROUND: Both direct-to-implant (DTI) and immediate free flap (FF) breast reconstruction following nipple sparing mastectomy (NSM) have been described in the literature. However, there is a paucity of comparative studies between these two techniques. Furthermore, existing studies do not control for factors influencing ischemic complications. CONCLUSION: Both DTI and immediate FF reconstruction can be safely offered to patients undergoing NSM while providing the benefit of a single reconstructive procedure. Copyright 2022 by the American Society of Plastic Surgeons. METHODS: A retrospective review of all NSMs performed at a single institution between January 2014 and January 2020 was performed. Immediate FF reconstructions were propensity score matched using probit regression to identify a comparable DTI cohort based on mastectomy weight, smoking, age, and history of prior radiotherapy. Primary outcomes of interest were 30-day ischemic complications. RESULTS: 108 NSMs performed in 79 patients were included. Average age was 45.7 +/- 10.5 years old and mean BMI was 27.1 +/- 4.8 kg/m2. There were 54 breasts in both the DTI group and the immediate FF group. Median mastectomy weight in the DTI group was 508 (264 IQR) grams as compared to 473 (303 IQR) in the FF group [(p=0.792). There was no significant difference in the rate of partial nipple-areola complex (NAC) necrosis in the DTI and FF groups (5.6 percent versus 3.7 percent, respectively; p=0.500) or mastectomy flap necrosis (5.6 percent versus 11.1 percent; p= 0.297). Both the DTI and FF groups had a total NAC necrosis rate of 1.9 percent (p= 0.752).
English
0032-1052
00006534-990000000-01392 [pii] 10.1097/PRS.0000000000010094 [doi]
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
MedStar Georgetown University Hospital/MedStar Washington Hospital Center
Plastic Surgery Residency
Surgery/Plastic Surgery
Journal Article