J Reconstr Microsurg 2018; 34(07): 530-536
DOI: 10.1055/s-0038-1641711
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

How Does Autologous Breast Reconstruction Impact Downtime?

Giovanni Zoccali
1   Department of Plastic and Reconstructive Surgery, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
,
Daniel Simon Rais
2   School of Medicine, Basel University, Basel, Switzerland
,
Jian Farhadi
1   Department of Plastic and Reconstructive Surgery, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
2   School of Medicine, Basel University, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

11 September 2017

22 February 2018

Publication Date:
13 April 2018 (online)

Preview

Abstract

Background Although autologous breast reconstruction is technically quite demanding, it offers the best outcomes in terms of durable results, patient perceptions, and postoperative pain. Many studies have focused on clinical outcomes and technical aspects of such procedures, but few have addressed the impact of various flaps on patient recovery times. This particular investigation entailed an assessment of commonly used flaps, examining the periods of time required to resume daily activities.

Methods Multiple choice questionnaires were administered to 121 patients after recovery from autologous reconstruction to determine the times required in returning to specific physical activities. To analyze results, the analysis of variance F-test was applied, and odds ratios (ORs) were determined.

Results Among the activities surveyed, recovery time was not always a function of free-flap surgery. Additional treatments and psychological effects also contributed. Adjuvant chemotherapy increased average downtime by 2 weeks, and postoperative irradiation prolonged recovery as much as 4 weeks. Patient downtime was unrelated to flap type, ranging from 2.9 to 21.3 weeks for various activities in question. Deep inferior epigastric perforator (DIEP) flaps yielded the highest OR and transverse upper gracilis (TUG) flaps the lowest.

Conclusion Compared with superior gluteal artery perforator and TUG flaps, the DIEP flap was confirmed as the gold standard in autologous breast reconstruction, conferring the shortest recovery times. All adjuvant therapies served to prolong patient recovery as well. Surgical issues, patient lifestyles, and donor-site availability are other important aspects of flap selection.