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A short-term comparison of expander prosthesis and DIEP flap in breast reconstructions : A prospective randomized study

Tallroth, Linda LU orcid ; Velander, Patrik LU and Klasson, Stina LU (2021) In Journal of Plastic, Reconstructive and Aesthetic Surgery 74(6). p.1193-1202
Abstract

Background: There is yet no clear consensus on which method is preferable in secondary breast reconstructions, prosthesis, or autologous tissue. Methods: In this first prospective randomized study, 29 women underwent reconstruction with expander prosthesis (EP) and 44 with deep inferior epigastric perforator (DIEP) flap. Inclusion started in 2012 and ended in 2018. Demographic data, complications, surgery time, hospital days, and consulting visits were recorded. Patient satisfaction was evaluated pre- and postoperatively using the BREAST-Q questionnaire. Health care costs were calculated based on rates from the financial year 2018. Here, we report the results related to the surgery and the first 30 postoperative days. Results: The two... (More)

Background: There is yet no clear consensus on which method is preferable in secondary breast reconstructions, prosthesis, or autologous tissue. Methods: In this first prospective randomized study, 29 women underwent reconstruction with expander prosthesis (EP) and 44 with deep inferior epigastric perforator (DIEP) flap. Inclusion started in 2012 and ended in 2018. Demographic data, complications, surgery time, hospital days, and consulting visits were recorded. Patient satisfaction was evaluated pre- and postoperatively using the BREAST-Q questionnaire. Health care costs were calculated based on rates from the financial year 2018. Here, we report the results related to the surgery and the first 30 postoperative days. Results: The two groups were comparable regarding demographics and clinical characteristics. Satisfaction with breasts, measured with BREAST-Q, was significantly higher in patients who had undergone reconstruction with DIEP flap compared with EP. Within 30 days after breast reconstruction, significantly fewer women (n = 2) in the EP group suffered complications compared to the DIEP flap group (n = 16; p < 0.01). The health care cost was also significantly higher in the DIEP flap group relative to the EP group (p < 0.01). Discussion: This patient cohort will be studied systematically over time, and results concerning the need for complementary surgery, costs, esthetics, and the patient-reported outcome (PRO) will be reported in future work. In this short-term report, EP seems to be preferable in regard to cost and complications, and DIEP flap is to choose from the patient's perspective.

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author
; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast reconstruction, Complication, cost, Deep inferior epigastric perforator (DIEP) flap, Expander prosthesis, Plastic surgery
in
Journal of Plastic, Reconstructive and Aesthetic Surgery
volume
74
issue
6
pages
1193 - 1202
publisher
Elsevier
external identifiers
  • scopus:85099145489
  • pmid:33436336
ISSN
1748-6815
DOI
10.1016/j.bjps.2020.10.104
project
DIEP flap and expander prosthesis in breast reconstruction
language
English
LU publication?
no
id
4677f787-7e09-456f-b102-c5d4cf8bf4e3
date added to LUP
2021-01-20 08:30:36
date last changed
2024-09-19 14:58:40
@article{4677f787-7e09-456f-b102-c5d4cf8bf4e3,
  abstract     = {{<p>Background: There is yet no clear consensus on which method is preferable in secondary breast reconstructions, prosthesis, or autologous tissue. Methods: In this first prospective randomized study, 29 women underwent reconstruction with expander prosthesis (EP) and 44 with deep inferior epigastric perforator (DIEP) flap. Inclusion started in 2012 and ended in 2018. Demographic data, complications, surgery time, hospital days, and consulting visits were recorded. Patient satisfaction was evaluated pre- and postoperatively using the BREAST-Q questionnaire. Health care costs were calculated based on rates from the financial year 2018. Here, we report the results related to the surgery and the first 30 postoperative days. Results: The two groups were comparable regarding demographics and clinical characteristics. Satisfaction with breasts, measured with BREAST-Q, was significantly higher in patients who had undergone reconstruction with DIEP flap compared with EP. Within 30 days after breast reconstruction, significantly fewer women (n = 2) in the EP group suffered complications compared to the DIEP flap group (n = 16; p &lt; 0.01). The health care cost was also significantly higher in the DIEP flap group relative to the EP group (p &lt; 0.01). Discussion: This patient cohort will be studied systematically over time, and results concerning the need for complementary surgery, costs, esthetics, and the patient-reported outcome (PRO) will be reported in future work. In this short-term report, EP seems to be preferable in regard to cost and complications, and DIEP flap is to choose from the patient's perspective.</p>}},
  author       = {{Tallroth, Linda and Velander, Patrik and Klasson, Stina}},
  issn         = {{1748-6815}},
  keywords     = {{Breast reconstruction; Complication; cost; Deep inferior epigastric perforator (DIEP) flap; Expander prosthesis; Plastic surgery}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1193--1202}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Plastic, Reconstructive and Aesthetic Surgery}},
  title        = {{A short-term comparison of expander prosthesis and DIEP flap in breast reconstructions : A prospective randomized study}},
  url          = {{http://dx.doi.org/10.1016/j.bjps.2020.10.104}},
  doi          = {{10.1016/j.bjps.2020.10.104}},
  volume       = {{74}},
  year         = {{2021}},
}