title: 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 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.
authors.affiliation: Department of Plastic and Aesthetic Surgery, Interdisciplinary Breast Centre, Sana-Kliniken, Gerresheim Hospital, Düsseldorf, Germany. c.andree@kliniken-duesseldorf.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Andree
authors.forename: Beatrix I J
authors.initials: BI
authors.lastname: Munder
authors.forename: Philipp
authors.initials: P
authors.lastname: Behrendt
authors.forename: Simone
authors.initials: S
authors.lastname: Hellmann
authors.forename: Werner
authors.initials: W
authors.lastname: Audretsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Voigt
authors.forename: Christoph
authors.initials: C
authors.lastname: Reis
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Raymund E
authors.initials: RE
authors.lastname: Horch
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Bach
mesh_terms: 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
chemical_list: D015718:Fibrin Tissue Adhesive