Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study

Summary: Introduction: Radiotherapy is a challenge in autologous breast reconstruction because of its impact on cutaneous and vascular systems. Hyperbaric oxygen therapy (HBOT) is a recognized treatment of radiation-related complications. We aimed to assess the impact of perioperative HBOT on irrad...

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Main Authors: Matteo Scampa, Jérôme Martineau, Sylvain Boet, Rodrigue Pignel, Daniel F. Kalbermatten, Carlo M. Oranges
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JPRAS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352587824001189
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author Matteo Scampa
Jérôme Martineau
Sylvain Boet
Rodrigue Pignel
Daniel F. Kalbermatten
Carlo M. Oranges
author_facet Matteo Scampa
Jérôme Martineau
Sylvain Boet
Rodrigue Pignel
Daniel F. Kalbermatten
Carlo M. Oranges
author_sort Matteo Scampa
collection DOAJ
description Summary: Introduction: Radiotherapy is a challenge in autologous breast reconstruction because of its impact on cutaneous and vascular systems. Hyperbaric oxygen therapy (HBOT) is a recognized treatment of radiation-related complications. We aimed to assess the impact of perioperative HBOT on irradiated breast microvascular reconstructive outcomes. Method: We reviewed the medical charts of patients who received radiotherapy and then underwent secondary free autologous breast reconstruction at our institution. Data on demographics, HBOT protocol, intervention characteristics and post-operative complications were collected. Outcomes of the irradiated patients were then compared between the HBOT and non-HBOT groups. Results: Fourteen patients were included (11 unilateral and 2 bilateral deep inferior epigastric artery perforator flaps and 1 free transverse rectus abdominis muscle flap). Seven patients received HBOT and 7 did not. In the non-HBOT group, there were 1 Clavien–Dindo grade II, 1 Clavien–Dindo grade IIIa and 2 Clavien–Dindo grade IIIb post-operative complications. In the HBOT group, there were 3 Clavien–Dindo grade I, 1 Clavien–Dindo grade IIIa and 2 Clavien–Dindo grade IIIb post-operative complications. The mean operative time was 452.3 minutes (SD ±62.4 minutes) for unilateral cases without HBOT and 457.8 minutes (SD ±102.1 minutes) with HBOT (p=0.913). Mean ischaemia time per flap without HBOT was 109.4 minutes (SD ±51.8 minutes) versus 80.1 minutes (SD ±37.7 minutes) in the HBOT group (p=0.249). Conclusion: This study provides insights into the potential of HBOT treatment in preparing patients with irradiated breast cancer for secondary autologous reconstruction.
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spelling doaj-art-7d321ebb02b442bd95a71da04c28bd712025-08-20T02:37:29ZengElsevierJPRAS Open2352-58782024-12-01421910.1016/j.jpra.2024.07.017Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative studyMatteo Scampa0Jérôme Martineau1Sylvain Boet2Rodrigue Pignel3Daniel F. Kalbermatten4Carlo M. Oranges5Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, SwitzerlandDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, SwitzerlandSubaquatic and Hyperbaric Medicine Unit, Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1205, Geneva, Switzerland; Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, K1H 8L6, Canada; Institut du Savoir Montfort, Ottawa, ON, K1K 0T2, CanadaSubaquatic and Hyperbaric Medicine Unit, Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1205, Geneva, SwitzerlandDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, SwitzerlandDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, Switzerland; Corresponding author: Carlo M. Oranges, MD, PhD, PD, Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland Phone: +41 (0)22 372 79 97Summary: Introduction: Radiotherapy is a challenge in autologous breast reconstruction because of its impact on cutaneous and vascular systems. Hyperbaric oxygen therapy (HBOT) is a recognized treatment of radiation-related complications. We aimed to assess the impact of perioperative HBOT on irradiated breast microvascular reconstructive outcomes. Method: We reviewed the medical charts of patients who received radiotherapy and then underwent secondary free autologous breast reconstruction at our institution. Data on demographics, HBOT protocol, intervention characteristics and post-operative complications were collected. Outcomes of the irradiated patients were then compared between the HBOT and non-HBOT groups. Results: Fourteen patients were included (11 unilateral and 2 bilateral deep inferior epigastric artery perforator flaps and 1 free transverse rectus abdominis muscle flap). Seven patients received HBOT and 7 did not. In the non-HBOT group, there were 1 Clavien–Dindo grade II, 1 Clavien–Dindo grade IIIa and 2 Clavien–Dindo grade IIIb post-operative complications. In the HBOT group, there were 3 Clavien–Dindo grade I, 1 Clavien–Dindo grade IIIa and 2 Clavien–Dindo grade IIIb post-operative complications. The mean operative time was 452.3 minutes (SD ±62.4 minutes) for unilateral cases without HBOT and 457.8 minutes (SD ±102.1 minutes) with HBOT (p=0.913). Mean ischaemia time per flap without HBOT was 109.4 minutes (SD ±51.8 minutes) versus 80.1 minutes (SD ±37.7 minutes) in the HBOT group (p=0.249). Conclusion: This study provides insights into the potential of HBOT treatment in preparing patients with irradiated breast cancer for secondary autologous reconstruction.http://www.sciencedirect.com/science/article/pii/S2352587824001189HyberbaricOxygenotherapyHBOTAutologousBreastFlap
spellingShingle Matteo Scampa
Jérôme Martineau
Sylvain Boet
Rodrigue Pignel
Daniel F. Kalbermatten
Carlo M. Oranges
Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study
JPRAS Open
Hyberbaric
Oxygenotherapy
HBOT
Autologous
Breast
Flap
title Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study
title_full Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study
title_fullStr Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study
title_full_unstemmed Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study
title_short Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study
title_sort hyperbaric oxygen therapy outcomes in post irradiated patient undergoing microvascular breast reconstruction a preliminary retrospective comparative study
topic Hyberbaric
Oxygenotherapy
HBOT
Autologous
Breast
Flap
url http://www.sciencedirect.com/science/article/pii/S2352587824001189
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