Background: In contrast to cosmetic abdominoplasty, abdominal flap harvest can result a high degree of morbidity to the abdominal wall. Poor abdominal wall aesthetics that can result following free flap harvest including a high abdominal incision and post-operative hernia or bulge. We report our experience in optimizing cosmesis of the abdominal donor site with the use of a low incision, fascial plication and routine mesh reinforcement. Methods: A retrospective chart review of patients who underwent breast reconstruction with free abdominal tissue transfer from 2013-2017. Pedicled flaps and superior inferior epigastric artery flaps were excluded. Patient demographics, oncologic history, ablative and reconstructive surgery details focusing on abdominal closure techniques, and postoperative complications were evaluated. Results: 135 patients were identified who underwent 223 abdominal free flaps. 59 (26.5%) DIEP flaps were harvested, while 160 (71.7%) msTRAM and 4 (1.8%) fTRAM flaps were harvested (p<0.0001). 160 (71.7%) donor sites closures utilized polypropylene mesh, 9 (4.0%) were closed with biologic mesh and 3 (1.3%) closures used no mesh (p<0.0001). No hernias were observed (0%), while 6 abdominal bulges were identified (2.7%). There were no differences in the rates of abdominal bulge after donor site closure in the DIEP compared with msTRAM and fTRAM groups (3.4% vs 2.4%, p=0.7). No patients required mesh explantation during the study follow up period. Conclusion: To parallel cosmetic abdominoplasty, our authors advocate for a low incision, fascial plication and routine mesh reinforcement of the abdominal wall following free flap harvest.
| Published in | Journal of Surgery (Volume 9, Issue 3) |
| DOI | 10.11648/j.js.20210903.16 |
| Page(s) | 128-133 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Autologous Breast Reconstruction, Abdominal Wall, Abdominal Bulge, Abdominoplasty
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APA Style
Peter Deptula, Dung Nguyen. (2021). Abdominal Wall Closure in Autologous Breast Reconstruction: Optimizing Aesthetics. Journal of Surgery, 9(3), 128-133. https://doi.org/10.11648/j.js.20210903.16
ACS Style
Peter Deptula; Dung Nguyen. Abdominal Wall Closure in Autologous Breast Reconstruction: Optimizing Aesthetics. J. Surg. 2021, 9(3), 128-133. doi: 10.11648/j.js.20210903.16
AMA Style
Peter Deptula, Dung Nguyen. Abdominal Wall Closure in Autologous Breast Reconstruction: Optimizing Aesthetics. J Surg. 2021;9(3):128-133. doi: 10.11648/j.js.20210903.16
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Download@article{10.11648/j.js.20210903.16,
author = {Peter Deptula and Dung Nguyen},
title = {Abdominal Wall Closure in Autologous Breast Reconstruction: Optimizing Aesthetics},
journal = {Journal of Surgery},
volume = {9},
number = {3},
pages = {128-133},
doi = {10.11648/j.js.20210903.16},
url = {https://doi.org/10.11648/j.js.20210903.16},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210903.16},
abstract = {Background: In contrast to cosmetic abdominoplasty, abdominal flap harvest can result a high degree of morbidity to the abdominal wall. Poor abdominal wall aesthetics that can result following free flap harvest including a high abdominal incision and post-operative hernia or bulge. We report our experience in optimizing cosmesis of the abdominal donor site with the use of a low incision, fascial plication and routine mesh reinforcement. Methods: A retrospective chart review of patients who underwent breast reconstruction with free abdominal tissue transfer from 2013-2017. Pedicled flaps and superior inferior epigastric artery flaps were excluded. Patient demographics, oncologic history, ablative and reconstructive surgery details focusing on abdominal closure techniques, and postoperative complications were evaluated. Results: 135 patients were identified who underwent 223 abdominal free flaps. 59 (26.5%) DIEP flaps were harvested, while 160 (71.7%) msTRAM and 4 (1.8%) fTRAM flaps were harvested (p<0.0001). 160 (71.7%) donor sites closures utilized polypropylene mesh, 9 (4.0%) were closed with biologic mesh and 3 (1.3%) closures used no mesh (p<0.0001). No hernias were observed (0%), while 6 abdominal bulges were identified (2.7%). There were no differences in the rates of abdominal bulge after donor site closure in the DIEP compared with msTRAM and fTRAM groups (3.4% vs 2.4%, p=0.7). No patients required mesh explantation during the study follow up period. Conclusion: To parallel cosmetic abdominoplasty, our authors advocate for a low incision, fascial plication and routine mesh reinforcement of the abdominal wall following free flap harvest.},
year = {2021}
}
TY - JOUR T1 - Abdominal Wall Closure in Autologous Breast Reconstruction: Optimizing Aesthetics AU - Peter Deptula AU - Dung Nguyen Y1 - 2021/05/27 PY - 2021 N1 - https://doi.org/10.11648/j.js.20210903.16 DO - 10.11648/j.js.20210903.16 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 128 EP - 133 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20210903.16 AB - Background: In contrast to cosmetic abdominoplasty, abdominal flap harvest can result a high degree of morbidity to the abdominal wall. Poor abdominal wall aesthetics that can result following free flap harvest including a high abdominal incision and post-operative hernia or bulge. We report our experience in optimizing cosmesis of the abdominal donor site with the use of a low incision, fascial plication and routine mesh reinforcement. Methods: A retrospective chart review of patients who underwent breast reconstruction with free abdominal tissue transfer from 2013-2017. Pedicled flaps and superior inferior epigastric artery flaps were excluded. Patient demographics, oncologic history, ablative and reconstructive surgery details focusing on abdominal closure techniques, and postoperative complications were evaluated. Results: 135 patients were identified who underwent 223 abdominal free flaps. 59 (26.5%) DIEP flaps were harvested, while 160 (71.7%) msTRAM and 4 (1.8%) fTRAM flaps were harvested (p<0.0001). 160 (71.7%) donor sites closures utilized polypropylene mesh, 9 (4.0%) were closed with biologic mesh and 3 (1.3%) closures used no mesh (p<0.0001). No hernias were observed (0%), while 6 abdominal bulges were identified (2.7%). There were no differences in the rates of abdominal bulge after donor site closure in the DIEP compared with msTRAM and fTRAM groups (3.4% vs 2.4%, p=0.7). No patients required mesh explantation during the study follow up period. Conclusion: To parallel cosmetic abdominoplasty, our authors advocate for a low incision, fascial plication and routine mesh reinforcement of the abdominal wall following free flap harvest. VL - 9 IS - 3 ER -
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