Photometric Comparison of Skin Color Match between Abdominal and Thigh-Based Free Flaps for Breast Reconstruction in White Patients.

IF 3.2 2区 医学 Q1 SURGERY Plastic and reconstructive surgery Pub Date : 2024-12-01 Epub Date: 2024-05-20 DOI:10.1097/PRS.0000000000011547
Maximilian Mahrhofer, Raphael Reichert, Frederic Fierdel, Xinchen Gu, Johannes Grabenwöger, Elisabeth Russe, Thomas Schoeller, Laurenz Weitgasser
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Abstract

Background: With the increasing demand for autologous breast reconstruction, different surgical techniques have emerged to provide patients with the best possible result tailored to their individual needs. The upper thigh provides an alternative tissue resource in patients where abdominal based flaps are not feasible. Although surgical outcomes and donor-site morbidity demonstrate favorable results using abdominal and thigh-based free flaps for autologous breast reconstruction, the differences in skin constitution and color between the two flap donor sites have not been investigated.

Methods: From the authors' flap database, 60 patients who underwent unilateral secondary breast reconstruction with free deep inferior epigastric perforator (DIEP) or transverse myocutaneous gracilis (TMG) flaps where randomly selected. In both cohorts, postoperative pictures were used for photometric color evaluation of the reconstructed breast using the delta E (ΔE) 2000 score at time A (1.5 to 3 months), time B (6 to 8 months), and time C (12 to 20 months). Standard univariate descriptive statistics and group comparisons were performed.

Results: The DIEP flap demonstrated a better skin color match at time A ( P < 0.001), time B ( P = 0.003), and time C ( P = 0.009). Over time, both flaps showed improved ΔE 2000 values, and patient age was only associated with higher ΔE 2000 values in TMG flaps after 1.5 to 3 months ( P = 0.021).

Conclusions: The study provides the first objective analysis of skin color match in secondary autologous breast reconstruction. The DIEP flap reconstruction shows a preferable color match compared with the TMG flap. Both free flaps demonstrate an improved skin color match 12 to 20 months after secondary breast reconstruction.

Clinical question/level of evidence: Therapeutic, III.

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白种人用于乳房再造的腹部游离皮瓣与大腿游离皮瓣肤色匹配的光度比较"。
背景:随着自体乳房重建需求的不断增加,出现了不同的手术技术,为患者提供符合其个人需求的最佳效果。在腹部皮瓣不可行的情况下,大腿上部为患者提供了另一种组织资源。虽然使用腹部和大腿游离皮瓣进行自体乳房重建的手术效果和供体部位发病率均显示出良好的结果,但尚未对两种皮瓣供体部位的皮肤构成和颜色差异进行研究:从我们的皮瓣数据库中随机抽取了 60 名使用游离 DIEP 或 TMG 皮瓣进行单侧二次乳房重建的患者。两组患者的术后照片均采用 Delta E 2000 评分法对重建乳房的颜色进行光度评估,评估时间分别为 A 时间(1.5 - 3 个月)、B 时间(6 - 8 个月)和 C 时间(12 - 20 个月)。进行了标准的单变量描述性统计和组间比较:结果:DIEP 皮瓣在 A 时间(p < 0.001)、B 时间(p = 0.003)和 C 时间(p = 0.009)显示出更好的肤色匹配。随着时间的推移,两种皮瓣的 Delta E 2000 值都有所提高,只有在 1.5 - 3 个月后,患者的年龄与 TMG 皮瓣较高的 Delta E 2000 值相关(p = 0.021):该研究首次对二次自体乳房重建中的肤色匹配进行了客观分析。与 TMG 皮瓣相比,DIEP 皮瓣重建显示出更佳的肤色匹配。两种游离皮瓣在二次乳房重建后 12-20 个月的皮肤颜色匹配度均有所提高。
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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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