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Handchir Mikrochir Plast Chir 2022; 54(04): 314-325
DOI: 10.1055/a-1858-5214
DOI: 10.1055/a-1858-5214
Originalarbeit
Erhöhung der Sicherheit in der mikrochirurgischen Brustrekonstruktion – Technik und Technologie
Increasing Safety in Microsurgical Breast Reconstruction – Technique and Technology
Zusammenfassung
Die mikrochirurgische Rekonstruktion mit freien Lappenplastiken hat sich als Standardverfahren in der Brustrekonstruktion etabliert. Dabei kann heute mit Hilfe des freien Gewebetransfers eine natürliche und ästhetisch anspruchsvolle Rekonstruktion der weiblichen Brust auch nach modifizierter radikaler Mastektomie und Bestrahlung erreicht werden. In den letzten Jahrzehnten wurden die mikrochirurgischen Techniken weitgehend standardisiert. Zahlreiche neue Entnahmestellen und Lappenplastiken wurden beschrieben, die entsprechend der lokalen Gewebeverfügbarkeit eine individualisierte Rekonstruktion mit großer Patientinnenzufriedenheit ermöglichen. Infolgedessen hat sich der Fokus der mikrochirurgischen Brustrekonstruktion vom reinen „Lappenüberleben“ hin zur Maximierung des ästhetischen Ergebnisses auch unter Berücksichtigung der Hebedefektmorbidität verlagert. In der vorliegenden Arbeit werden aktuelle Entwicklungen auf dem Gebiet mit einem besonderen Fokus auf Operationstechniken und Technologien, die dazu beitragen, die Sicherheit der mikrochirurgischen Brustrekonstruktion zu erhöhen, beschrieben.
Abstract
Microsurgical reconstruction has established itself as a standard procedure in breast reconstruction as it permits creation of a natural and aesthetically appealing breast mound, even after modified radical mastectomy and radiation. In the past few decades numerous new free flap donor-sites have been described that permit an individualized approach to reconstruction, thus, resulting in a high level of patient satisfaction. Paralleling these technical innovations, the focus of microsurgical breast reconstruction has shifted from mere “flap success” to “aesthetic outcome”, while also taking into account the respective donor-site morbidity. Here, the authors discuss contemporary developments in the field with a particular focus on surgical techniques and technologies that contribute to increasing the safety of microsurgical breast reconstruction.
Publication History
Received: 09 January 2022
Accepted: 16 May 2022
Article published online:
04 July 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
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