Subscribe to RSS
DOI: 10.1055/s-0028-1104553
Patient Body Mass Index and Perforator Quality in Abdomen-Based Free-Tissue Transfer for Breast Reconstruction
Publication History
Publication Date:
15 December 2008 (online)
![](https://www.thieme-connect.de/media/jrm/200904/lookinside/thumbnails/10.1055-s-0028-1104553-1.jpg)
ABSTRACT
Body mass index (BMI) must be considered when selecting patients suitable for abdomen-based microsurgical breast reconstruction. It is unknown whether BMI or age affects quality or quantity of abdominal wall perforating blood vessels. The purpose of this study was to identify differences in abdominal wall perforating blood vessels among patients with different BMI and age. A retrospective review was conducted of 66 patients undergoing abdomen-based microsurgical breast reconstruction tissue transfer from 2000 to 2006. Median age was 48.6 years (± 8.2). Patients were divided into BMI < 25 (28 patients), BMI 25 to 30 (26 patients), or BMI > 30 (12 patients). Perforator size and location was determined by ultrasound data. There was a greater number of perforators in horizontal zone II compared with the remaining zones (p < 0.05, Bonferroni corrected). There were no differences between age or BMI and the number of perforators or average perforator size per patient. A significant positive linear association was found between the average perforator diameter and total number of abdominal wall perforators. We concluded there is no anatomical difference in perforator quality among patients with varying BMIs ≤ 35. Zone II remains the most likely region for quality perforators. Abdomen-based microsurgical breast reconstruction is reasonable and safe for women with a BMI < 35.
KEYWORDS
Perforator - body mass index - abdomen
REFERENCES
- 1 Allen R J, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg. 1994; 32(1) 32-38
- 2 Blondeel P N, Boeckx W D. Refinements in free flap breast reconstruction: the free bilateral deep inferior epigastric perforator flap anastomosed to the internal mammary artery. Br J Plast Surg. 1994; 47(7) 495-501
- 3 Allen R J, Tucker C J. Superior gluteal artery perforator free flap for breast reconstruction. Plast Reconstr Surg. 1995; 95(7) 1207-1212
- 4 Blondeel P N, Beyens G, Verhaeghe R et al.. Doppler flowmetry in the planning of perforator flaps. Br J Plast Surg. 1998; 51(3) 202-209
- 5 Giunta R E, Geisweid A, Feller A M. The value of preoperative Doppler sonography for planning free perforator flaps. Plast Reconstr Surg. 2000; 105(7) 2381-2386
- 6 Rozen W M, Phillips T J, Ashton M W et al.. Preoperative imaging for DIEA perforator flaps: a comparative study of computed tomographic angiography and Doppler ultrasound. Plast Reconstr Surg. 2008; 121(1 Suppl) 1-8
- 7 Masia J, Clavero J, Larrañaga J et al.. Multidetector-row computed tomography in the planning of abdominal perforator flaps. J Plast Reconstr Aesthet Surg. 2006; 59(6) 594-599
- 8 Chang D W, Wang B, Robb G et al.. Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction. Plast Reconstr Surg. 2000; 105(5) 1640-1648
- 9 Garvey P B, Buchel E W, Pockaj B A, Gray R J, Samson T D. The deep inferior epigastric perforator flap for breast reconstruction in overweight and obese patients. Plast Reconstr Surg. 2005; 115(2) 447-457
- 10 Rand R P, Cramer M M, Strandness D E. Color-flow duplex scanning in the preoperative assessment of TRAM flap perforators: a report of 32 consecutive patients. Plast Reconstr Surg. 1994; 93(3) 453-459
- 11 Fukaya E, Grossman R, Saloner D et al.. Magnetic resonance angiography for free fibula flap transfer. J Reconstr Microsurg. 2007; 23(4) 205-211
David W MathesM.D.
Chief, Seattle Veterans Affairs Hospital, Assistant Professor, Division of Plastic Surgery
University of Washington Medical Center, 1959 NE Pacific Street, Box 356410, Seattle, WA 98115
Email: dwmathes@u.washington.edu