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.
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.
Andree
Christoph
C
Department of Plastic and Aesthetic Surgery, Interdisciplinary Breast Centre, Sana-Kliniken, Gerresheim Hospital, Düsseldorf, Germany. c.andree@kliniken-duesseldorf.de
Munder
Beatrix I J
BI
Behrendt
Philipp
P
Hellmann
Simone
S
Audretsch
Werner
W
Voigt
Matthias
M
Reis
Christoph
C
Beckmann
Matthias W
MW
Horch
Raymund E
RE
Bach
Alexander D
AD
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D019074:Epigastric Arteries / Q000601:surgery; D005260:Female; D015718:Fibrin Tissue Adhesive; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D017568:Rectus Abdominis / Q000098:blood supply / Q000601:surgery; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive