title: Patient body mass index and perforator quality in abdomen-based free-tissue transfer for breast reconstruction.
abstract: Body mass index (BMI) must be considered when selecting patients suitable for abdomen-based microsurgical breast reconstruction. It is unknown whether BMI or age affects quality or quantity of abdominal wall perforating blood vessels. The purpose of this study was to identify differences in abdominal wall perforating blood vessels among patients with different BMI and age. A retrospective review was conducted of 66 patients undergoing abdomen-based microsurgical breast reconstruction tissue transfer from 2000 to 2006. Median age was 48.6 years (+/- 8.2). Patients were divided into BMI < 25 (28 patients), BMI 25 to 30 (26 patients), or BMI > 30 (12 patients). Perforator size and location was determined by ultrasound data. There was a greater number of perforators in horizontal zone II compared with the remaining zones (P < 0.05, Bonferroni corrected). There were no differences between age or BMI and the number of perforators or average perforator size per patient. A significant positive linear association was found between the average perforator diameter and total number of abdominal wall perforators. We concluded there is no anatomical difference in perforator quality among patients with varying BMIs <or= 35. Zone II remains the most likely region for quality perforators. Abdomen-based microsurgical breast reconstruction is reasonable and safe for women with a BMI < 35.
authors.affiliation: Division of Plastic Surgery, University of Washington Medical Center, Seattle, Washington 98115, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Scott
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Sullivan
authors.forename: Daniel
authors.initials: D
authors.lastname: Liu
authors.forename: Kari
authors.initials: K
authors.lastname: Keys
authors.forename: F Frank
authors.initials: FF
authors.lastname: Isik
authors.forename: Hakim
authors.initials: H
authors.lastname: Said
authors.forename: David W
authors.initials: DW
authors.lastname: Mathes
mesh_terms: D034861:Abdominal Wall / Q000098:blood supply* / Q000601:surgery; D000704:Analysis of Variance; D015992:Body Mass Index; D005260:Female; D006801:Humans; D016014:Linear Models; D016462:Mammaplasty / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome