Complications of delayed reconstructive and plastic surgery after radical mastectomy

Objective: to assess the nature and frequency of complications due to different types of delayed reconstructive and plastic surgery (DRPS) after radical mastectomy (RME).Subjects and methods. The investigators analyzed the results of treating 31 patients after RME in 2001 to 2014. DRPS was performed...

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Main Authors: A. D. Zikiryakhodzhaev, V. V. Efanov, F. N. Usov, M. M. Ismailova
Format: Article
Language:Russian
Published: ABV-press 2015-07-01
Series:Опухоли женской репродуктивной системы
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Online Access:https://ojrs.abvpress.ru/ojrs/article/view/430
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author A. D. Zikiryakhodzhaev
V. V. Efanov
F. N. Usov
M. M. Ismailova
author_facet A. D. Zikiryakhodzhaev
V. V. Efanov
F. N. Usov
M. M. Ismailova
author_sort A. D. Zikiryakhodzhaev
collection DOAJ
description Objective: to assess the nature and frequency of complications due to different types of delayed reconstructive and plastic surgery (DRPS) after radical mastectomy (RME).Subjects and methods. The investigators analyzed the results of treating 31 patients after RME in 2001 to 2014. DRPS was performed 4 months to 15.5 years (more frequently 1 to 3 years) following RME. To choose an optimal reconstructive method, it should be kept in mind the following factors: breast size and ptosis, the patients’ somatic status, the presence of scars in the donor area, and radiotherapy to the chest. The breast was repaired using a TRAM flap in 22 patients. Eight cases underwent two-step reconstruction, by setting a tissue expander at Step 1 and replacing it by a silicone implant at Step 2. In one patient, a Becker expander/implant was used as a plastic component for delayed breast reconstructionin order to make a bed with a latissimus dorsi fragment.Results. Complications were observed in 8 (25.8 %) patients. The largest number of complications occurred in 6 cases after breast reconstruction using a TRAM flap. There were complications, such as inferior epigastric arterial thrombosis; marginal necroses of a displaced TRAM flap; hematoma in the postoperative wound region; implant bed infection; and wound edge diastasis in the donor area. In virtually all complicated cases, the patients received multimodality (75 %) and combined (12.5 %) treatments before DRPS.Conclusion. Beam radiotherapy and chemotherapy increase the risk of complications after both reconstructive plastic surgery with implants and the use of autologous tissues. Two-step reconstruction applying implants provided a good cosmetic effect and the least rate of complications.
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series Опухоли женской репродуктивной системы
spelling doaj-art-80007765d6524fbfa175c44cb8b0102f2025-08-20T03:37:11ZrusABV-pressОпухоли женской репродуктивной системы1994-40981999-86272015-07-01112313410.17650/1994-4098-2015-11-2-31-34445Complications of delayed reconstructive and plastic surgery after radical mastectomyA. D. Zikiryakhodzhaev0V. V. Efanov1F. N. Usov2M. M. Ismailova3P.A. Herzen Moscow Oncology Research Institute – Branch of National Medical Radiological Research Center, Ministry of Health of Russia; 3 2nd Botkinsky Proezd, Moscow, 125284, RussiaP.A. Herzen Moscow Oncology Research Institute – Branch of National Medical Radiological Research Center, Ministry of Health of Russia; 3 2nd Botkinsky Proezd, Moscow, 125284, RussiaP.A. Herzen Moscow Oncology Research Institute – Branch of National Medical Radiological Research Center, Ministry of Health of Russia; 3 2nd Botkinsky Proezd, Moscow, 125284, RussiaP.A. Herzen Moscow Oncology Research Institute – Branch of National Medical Radiological Research Center, Ministry of Health of Russia; 3 2nd Botkinsky Proezd, Moscow, 125284, RussiaObjective: to assess the nature and frequency of complications due to different types of delayed reconstructive and plastic surgery (DRPS) after radical mastectomy (RME).Subjects and methods. The investigators analyzed the results of treating 31 patients after RME in 2001 to 2014. DRPS was performed 4 months to 15.5 years (more frequently 1 to 3 years) following RME. To choose an optimal reconstructive method, it should be kept in mind the following factors: breast size and ptosis, the patients’ somatic status, the presence of scars in the donor area, and radiotherapy to the chest. The breast was repaired using a TRAM flap in 22 patients. Eight cases underwent two-step reconstruction, by setting a tissue expander at Step 1 and replacing it by a silicone implant at Step 2. In one patient, a Becker expander/implant was used as a plastic component for delayed breast reconstructionin order to make a bed with a latissimus dorsi fragment.Results. Complications were observed in 8 (25.8 %) patients. The largest number of complications occurred in 6 cases after breast reconstruction using a TRAM flap. There were complications, such as inferior epigastric arterial thrombosis; marginal necroses of a displaced TRAM flap; hematoma in the postoperative wound region; implant bed infection; and wound edge diastasis in the donor area. In virtually all complicated cases, the patients received multimodality (75 %) and combined (12.5 %) treatments before DRPS.Conclusion. Beam radiotherapy and chemotherapy increase the risk of complications after both reconstructive plastic surgery with implants and the use of autologous tissues. Two-step reconstruction applying implants provided a good cosmetic effect and the least rate of complications.https://ojrs.abvpress.ru/ojrs/article/view/430delayed reconstructive and plastic surgerytram flaptwo-step reconstructiontissue expandersilicone implantradical mastectomy
spellingShingle A. D. Zikiryakhodzhaev
V. V. Efanov
F. N. Usov
M. M. Ismailova
Complications of delayed reconstructive and plastic surgery after radical mastectomy
Опухоли женской репродуктивной системы
delayed reconstructive and plastic surgery
tram flap
two-step reconstruction
tissue expander
silicone implant
radical mastectomy
title Complications of delayed reconstructive and plastic surgery after radical mastectomy
title_full Complications of delayed reconstructive and plastic surgery after radical mastectomy
title_fullStr Complications of delayed reconstructive and plastic surgery after radical mastectomy
title_full_unstemmed Complications of delayed reconstructive and plastic surgery after radical mastectomy
title_short Complications of delayed reconstructive and plastic surgery after radical mastectomy
title_sort complications of delayed reconstructive and plastic surgery after radical mastectomy
topic delayed reconstructive and plastic surgery
tram flap
two-step reconstruction
tissue expander
silicone implant
radical mastectomy
url https://ojrs.abvpress.ru/ojrs/article/view/430
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AT vvefanov complicationsofdelayedreconstructiveandplasticsurgeryafterradicalmastectomy
AT fnusov complicationsofdelayedreconstructiveandplasticsurgeryafterradicalmastectomy
AT mmismailova complicationsofdelayedreconstructiveandplasticsurgeryafterradicalmastectomy