Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction
Background:. Exposure of internal mammary vessels in autologous breast reconstruction often requires removal of a rib cartilage segment, which can lead to breast contour deformity. This study evaluated the use of diced cartilage (DC) to counteract substance loss in the microvascular anastomosis area...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006429 |
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| author | Ulf Dornseifer, MD, PhD My L. Truong Stephan Grumbrecht, MD Peter P. Pfeiler, MD Uli D. Haide, MD, DMD Philipp Moog, MD, PhD Michael Kimelman, MD |
| author_facet | Ulf Dornseifer, MD, PhD My L. Truong Stephan Grumbrecht, MD Peter P. Pfeiler, MD Uli D. Haide, MD, DMD Philipp Moog, MD, PhD Michael Kimelman, MD |
| author_sort | Ulf Dornseifer, MD, PhD |
| collection | DOAJ |
| description | Background:. Exposure of internal mammary vessels in autologous breast reconstruction often requires removal of a rib cartilage segment, which can lead to breast contour deformity. This study evaluated the use of diced cartilage (DC) to counteract substance loss in the microvascular anastomosis area.
Methods:. This retrospective, single-center cohort study included all breast reconstructions in which DC was used from October 2021 to June 2023. Reconstructions using DC were subdivided based on previous breast radiotherapy (DC versus DC with prior breast radiotherapy [DCR]). The control group consisted of an equal number of consecutive reconstructions performed before the use of DC. The effect of DC on breast contour was investigated using magnetic resonance imaging (>6 months postoperative) and photographic documentation (6-month follow-up).
Results:. DC was used in 114 of 173 included reconstructions (DC, n = 55; DCR, n = 59; control, n = 59). Magnetic resonance imaging analysis revealed less soft tissue sinking into resection zones in both DC groups (DC 0.2 ± 1.3 mm versus control 6.0 ± 1.6 mm, P = 0.002; DCR 0.4 ± 1.6 mm versus control 6.0 ± 1.6 mm, P < 0.003). Previous irradiation did not affect DC stability. The photographs indicated that there were no deformities after DC use, but deformities occurred in 13.6% of patients in the control group (P < 0.05). Flap failure did not occur in any group.
Conclusions:. DC is a safe procedure that prevents contour deformities associated with rib cartilage removal in breast reconstruction, regardless of prior breast irradiation. |
| format | Article |
| id | doaj-art-b1ee6e40402b473796dce3a016d2bf90 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-b1ee6e40402b473796dce3a016d2bf902025-01-24T09:19:58ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-01-01131e642910.1097/GOX.0000000000006429202501000-00038Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast ReconstructionUlf Dornseifer, MD, PhD0My L. Truong1Stephan Grumbrecht, MD2Peter P. Pfeiler, MD3Uli D. Haide, MD, DMD4Philipp Moog, MD, PhD5Michael Kimelman, MD6From the * Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, GermanyFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, Germany† Breast Imaging Division, Radiologie Augsburg Friedberg/Breast Center Augsburg, Augsburg, GermanyFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, GermanyFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, Germany‡ Clinic and Policlinic for Plastic, Reconstructive and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.From the * Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, GermanyBackground:. Exposure of internal mammary vessels in autologous breast reconstruction often requires removal of a rib cartilage segment, which can lead to breast contour deformity. This study evaluated the use of diced cartilage (DC) to counteract substance loss in the microvascular anastomosis area. Methods:. This retrospective, single-center cohort study included all breast reconstructions in which DC was used from October 2021 to June 2023. Reconstructions using DC were subdivided based on previous breast radiotherapy (DC versus DC with prior breast radiotherapy [DCR]). The control group consisted of an equal number of consecutive reconstructions performed before the use of DC. The effect of DC on breast contour was investigated using magnetic resonance imaging (>6 months postoperative) and photographic documentation (6-month follow-up). Results:. DC was used in 114 of 173 included reconstructions (DC, n = 55; DCR, n = 59; control, n = 59). Magnetic resonance imaging analysis revealed less soft tissue sinking into resection zones in both DC groups (DC 0.2 ± 1.3 mm versus control 6.0 ± 1.6 mm, P = 0.002; DCR 0.4 ± 1.6 mm versus control 6.0 ± 1.6 mm, P < 0.003). Previous irradiation did not affect DC stability. The photographs indicated that there were no deformities after DC use, but deformities occurred in 13.6% of patients in the control group (P < 0.05). Flap failure did not occur in any group. Conclusions:. DC is a safe procedure that prevents contour deformities associated with rib cartilage removal in breast reconstruction, regardless of prior breast irradiation.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006429 |
| spellingShingle | Ulf Dornseifer, MD, PhD My L. Truong Stephan Grumbrecht, MD Peter P. Pfeiler, MD Uli D. Haide, MD, DMD Philipp Moog, MD, PhD Michael Kimelman, MD Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction Plastic and Reconstructive Surgery, Global Open |
| title | Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction |
| title_full | Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction |
| title_fullStr | Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction |
| title_full_unstemmed | Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction |
| title_short | Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction |
| title_sort | use of diced cartilage for management of internal mammary vessel exposure sites in autologous breast reconstruction |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006429 |
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