Abdominal Wall Reinforcement Using OviTex after Deep Inferior Epigastric Perforator Flap

Alec S. McCranie; Caitlin Blades; Steven Dawson; Jose A. Foppiani; Taylor Allenby; Julian Winocour; Justin Cohen; David Mathes; Christodoulos Kaoutzanis

doi:10.1055/a-2555-2348

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg
DOI: 10.1055/a-2555-2348

Original Article

Abdominal Wall Reinforcement Using OviTex after Deep Inferior Epigastric Perforator Flap

Alec S. McCranie

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

,

Caitlin Blades

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

,

Steven Dawson

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

,

Jose A. Foppiani

²Department of Plastic and Reconstructive Surgery, Beth Isreal Deaconess Medical Center, Boston, Massachusetts

,

Taylor Allenby

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

,

Julian Winocour

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

,

Justin Cohen

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

,

David Mathes

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

,

Christodoulos Kaoutzanis

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

› Institutsangaben

Abstract

Background

Abdominal wall bulges and hernias are not uncommon complications following deep inferior epigastric perforator (DIEP) flap harvest. Abdominal wall reinforcement using synthetic meshes has been found to decrease bulges by up to 70%; however, such meshes can be associated with other issues such as seromas and infections. Reinforced tissue matrix (RTM) mesh can be used for abdominal wall reinforcement due to its ability to recruit fibroblasts and provide a scaffold for cellular proliferation. There is no literature on the use of OviTex mesh for abdominal wall reinforcement following DIEP flap harvest. Therefore, this study aimed to evaluate the efficacy and safety of its use in this setting.

Methods

A retrospective review was performed on patients undergoing DIEP flap harvest between January 2020 and June 2023. Patients who had completed at least 12 months of follow-up visits were included. Descriptive, univariate, and multiple logistic regression analyses were completed.

Results

A total of 199 patients were included. The mean age at the time of surgery was 51.1 ± 10.0 years and the mean body mass index (BMI) was 30.2 ± 5.9 kg/m². Abdominal wall reinforcement was completed in 85 (42.7%) patients. Patients who had OviTex placed developed fewer bulges compared to the non-mesh cohort (0% vs. 5.3%, p = 0.04). Furthermore, OviTex mesh did not increase adverse events and was not significantly different in seroma/hematoma rates when compared to the non-mesh cohort (10.6% vs. 5.3%, p = 0.26).

Conclusion

This study demonstrates that OviTex mesh is safe and efficacious in reducing the rate of bulges following DIEP flap harvest without increasing other complications.

Keywords

deep inferior epigastric perforator flap - mesh - breast reconstruction - hernia - bulge

Volltext

Referenzen

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