The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction
Abstract
:1. Introduction
2. Methods
2.1. Surgical Procedure
2.2. Computed Tomographic Angiogram Measurements
2.3. Patients
2.4. Statistical Analysis
3. Results
4. Discussion
4.1. Donor-Site Complications: Presumed Causes and Impact
4.2. Obesity, BMI, and Areas of Fat as Predictors of Donor-Site Complications
4.3. The Potential of Other Morphometric Measurements
4.4. Personalised Medicine
4.5. Study Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Grade | Definition | Example |
---|---|---|
I | Deviation from normal postoperative course with no need for pharmacological or surgical interventions. * |
|
II | Pharmacological treatment required. |
|
IIIa IIIb | Requiring surgical intervention
|
|
IV | Life threatening complication. |
|
V | Death of a patient. |
|
Clavien–Dindo | Donor Site Complication | Therapeutic Management | Number of Events |
---|---|---|---|
I | - Delayed wound healing | - Dressing changes | 3 |
- Seroma | - Needle aspiration | 2 | |
Seroma | Observation | 2 | |
IIIa | - Delayed wound healing | - Vacuum-asissted closure therapy | 1 |
IIIb | - Seroma | - Surgical seroma evacuation and drainage | 2 |
- Seroma | - Surgical debridement | 2 | |
- Postoperative wound infection | - Sclerotherapy and surgical revision | 1 |
Variable | Normal Weight (n = 44) | Obese (n = 46) | Total | p-Value | |
---|---|---|---|---|---|
Area of subcutaneous fat (cm2) | Mean (SD) | 191.3 (53.2) | 348.6 (82.9) | 271.7 (105.3) | 0.000 |
Area of intraabdominal fat (cm2) | Mean (SD) | 26.1 (28.6) | 67.1 (41.7) | 47.1 (41.2) | 0.000 |
Area of omental fat (cm2) | Mean (SD) | 8.4 (9.1) | 27.8 (24.1) | 18.3 (20.7) | 0.000 |
Area of mesenteric fat (cm2) | Mean (SD) | 17.7 (25.7) | 39.3 (26.5) | 28.8 (28.1) | 0.000 |
Area of retroperitoneal fat (cm2) | Mean (SD) | 29.5 (22.5) | 53.6 (25.3) | 41.8 (26.7) | 0.000 |
Variable | OR (95% CI, p-Value) | OR (95% CI, p-Value) |
---|---|---|
Univariable | Multivariable | |
Diabetes mellitus | 5.47 (1.04–28.77, p = 0.042) | 4.99 (0.84–27.40, p = 0.062) |
Area of omental fat | 1.03 (1.00–1.06 p = 0.018) | 1.03 (1.00–1.06, p = 0.022) |
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Meyer, M.O.; Handschin, T.M.; Boll, D.T.; Chammartin, F.; Schaefer, D.J.; Haug, M.D.; Kappos, E.A. The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction. J. Clin. Med. 2020, 9, 2645. https://doi.org/10.3390/jcm9082645
Meyer MO, Handschin TM, Boll DT, Chammartin F, Schaefer DJ, Haug MD, Kappos EA. The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction. Journal of Clinical Medicine. 2020; 9(8):2645. https://doi.org/10.3390/jcm9082645
Chicago/Turabian StyleMeyer, Muriel O., Tristan M. Handschin, Daniel T. Boll, Frédérique Chammartin, Dirk J. Schaefer, Martin D. Haug, and Elisabeth A. Kappos. 2020. "The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction" Journal of Clinical Medicine 9, no. 8: 2645. https://doi.org/10.3390/jcm9082645