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Blood flow dynamics and sensitivity in breasts after reconstruction with DIEP-flap

Klasson, Stina LU ; Svensson, Karin; Wollmer, Per LU ; Velander, Patrik LU and Svensson, Henry LU (2014) In Journal of Plastic Surgery and Hand Surgery 48(6). p.407-411
Abstract
A method of breast reconstruction is based on the Deep Inferior Epigastric Perforator (DIEP) technique. Skin and fat are transplanted from the abdomen to the chest; blood vessels are reconnected through microsurgery. Nerves are, however, left unconnected. This study aims to evaluate the blood flow and reinnervation of blood vessels and skin in breasts reconstructed by DIEP flaps without neural repair. In all, DIEP flaps of 10 patients were tested at an average of 16.3 months postoperatively. Blood flow was assessed by PeriScan PIM II System, both before and after indirect heating. Tactile perception threshold was assessed by Semmes-Weinstein monofilament and thermal sensibility by SENSELab MSA Thermotest. The patients' contralateral... (More)
A method of breast reconstruction is based on the Deep Inferior Epigastric Perforator (DIEP) technique. Skin and fat are transplanted from the abdomen to the chest; blood vessels are reconnected through microsurgery. Nerves are, however, left unconnected. This study aims to evaluate the blood flow and reinnervation of blood vessels and skin in breasts reconstructed by DIEP flaps without neural repair. In all, DIEP flaps of 10 patients were tested at an average of 16.3 months postoperatively. Blood flow was assessed by PeriScan PIM II System, both before and after indirect heating. Tactile perception threshold was assessed by Semmes-Weinstein monofilament and thermal sensibility by SENSELab MSA Thermotest. The patients' contralateral breasts were used as controls. The blood flow of the flaps was statistically significantly lower than in the control breasts, both before and after indirect heating. The change in blood flow after indirect heating did, however, not significantly differ when comparing the breasts. All flaps regained deep pressure sensibility in all four quadrants. Five patients regained even better sensibility in one of their quadrants. Seven patients regained perception of cold stimuli, five perceived warmth. This study has shown that skin blood flow regulation is present in DIEP flaps 1 year after reconstruction. Blood flow dynamics are very similar to those in the normal breast. There is also a recovery of tactile and thermal sensibility, but this study has not shown any clear parallels between recovery blood flow, tactile sensibility and thermal sensibility. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast reconstruction, perforator, microvascular, plastic surgery, tumour
in
Journal of Plastic Surgery and Hand Surgery
volume
48
issue
6
pages
407 - 411
publisher
Taylor & Francis
external identifiers
  • wos:000345214500010
  • scopus:84911396369
ISSN
2000-656X
DOI
10.3109/2000656X.2014.903194
language
English
LU publication?
yes
id
4c7745de-505a-4bb4-a397-e6fa2881df96 (old id 4982930)
date added to LUP
2015-02-03 07:12:05
date last changed
2017-08-27 03:42:09
@article{4c7745de-505a-4bb4-a397-e6fa2881df96,
  abstract     = {A method of breast reconstruction is based on the Deep Inferior Epigastric Perforator (DIEP) technique. Skin and fat are transplanted from the abdomen to the chest; blood vessels are reconnected through microsurgery. Nerves are, however, left unconnected. This study aims to evaluate the blood flow and reinnervation of blood vessels and skin in breasts reconstructed by DIEP flaps without neural repair. In all, DIEP flaps of 10 patients were tested at an average of 16.3 months postoperatively. Blood flow was assessed by PeriScan PIM II System, both before and after indirect heating. Tactile perception threshold was assessed by Semmes-Weinstein monofilament and thermal sensibility by SENSELab MSA Thermotest. The patients' contralateral breasts were used as controls. The blood flow of the flaps was statistically significantly lower than in the control breasts, both before and after indirect heating. The change in blood flow after indirect heating did, however, not significantly differ when comparing the breasts. All flaps regained deep pressure sensibility in all four quadrants. Five patients regained even better sensibility in one of their quadrants. Seven patients regained perception of cold stimuli, five perceived warmth. This study has shown that skin blood flow regulation is present in DIEP flaps 1 year after reconstruction. Blood flow dynamics are very similar to those in the normal breast. There is also a recovery of tactile and thermal sensibility, but this study has not shown any clear parallels between recovery blood flow, tactile sensibility and thermal sensibility.},
  author       = {Klasson, Stina and Svensson, Karin and Wollmer, Per and Velander, Patrik and Svensson, Henry},
  issn         = {2000-656X},
  keyword      = {Breast reconstruction,perforator,microvascular,plastic surgery,tumour},
  language     = {eng},
  number       = {6},
  pages        = {407--411},
  publisher    = {Taylor & Francis},
  series       = {Journal of Plastic Surgery and Hand Surgery},
  title        = {Blood flow dynamics and sensitivity in breasts after reconstruction with DIEP-flap},
  url          = {http://dx.doi.org/10.3109/2000656X.2014.903194},
  volume       = {48},
  year         = {2014},
}