A retrospective investigation of abdominal visceral fat, body mass index (BMI), and active smoking as risk factors for donor site wound healing complications after free DIEP flap breast reconstructions

被引：24

作者：

Timmermans, Floyd W. ^{[1
,2
]}

Westland, Pedrou B. ^{[1
]}

Hummelink, Stefan ^{[1
]}

Schreurs, Joep ^{[1
]}

Hameeteman, Marijn ^{[1
]}

Ulrich, Dietmar J. O. ^{[1
]}

Slater, Nicholas J. ^{[1
]}

机构：

[1] Radboud Univ Hosp Radboudumc, Dept Plast & Reconstruct Surg, Geert Grooteplein Zuid 10, NL-6525 GA Nijmegen, Netherlands

[2] Vrije Univ Amsterdam, Med Ctr VUmc, Dept Plast Reconstruct & Hand Surg, Boelelaan 1117,ZH 4D120, NL-1081 HV Amsterdam, Netherlands

来源：

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY | 2018年 / 71卷 / 06期

关键词：

DIEP; Breast Reconstruction; Donor Site Complications; Smoking; Morphometrics; Visceral Fat; INFERIOR EPIGASTRIC PERFORATOR; FREE TRAM FLAP; OBESE-PATIENTS; OUTCOMES;

D O I：

10.1016/j.bjps.2018.03.003

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: The deep inferior epigastric artery perforator (DIEP) flap is one of the most common techniques for breast reconstruction. Body mass index (BMI) is considered as an important predictor of donor site healing complications such as wound dehiscence. The use of computed tomography (CT) proved to be a precise and objective method to assess visceral adipose tissue. It remains unclear whether quantification of visceral fat provides more accurate predictions of abdominal wound healing complications than BMI. Patients and Methods: A total of 97 patients with DIEP flap were retrospectively evaluated. Patients' abdominal visceral fat (AVF) was quantified on CT angiography (CTA). The patients were postoperatively assessed for abdominal wound healing complications. We analyzed for the correlations between AVF, BMI, and dehiscence and established a logistic regression model to assess the potential high-profile predictors in anatomic and patient characteristics such as weight, smoking, and diabetes. Results: We included 97 patients, and of them, 24 patients (24.7%) had some degree of abdominal dehiscence. No significant differences were observed between the dehiscence group and the non-dehiscence group, except for smoking (p = 0.002). We found a significant correlation between AVF and BMI (R = 0.282, p = 0.005), but neither was significant in predicting donor site dehiscence. Smoking greatly increased the likelihood of developing wound dehiscence (OR = 11.4, p = < 0.001). Conclusions: AVF and BMI were not significant predictors of abdominal wound healing complications after DIEP flap reconstruction. This study established active smoking (OR = 11.4, p = < 0.001) as the significant risk factor that contributed to the development of abdominal wound dehiscence in patients with DIEP. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

引用

页码：827 / 832

页数：6