DIEP Donor Site Satisfaction between Patients with and without History of Pregnancy

David Chon-Fok Cheong; Allen Wei-Jiat Wong; Shu-Wei Kao; Shu-Ying Chang; Jung-Ju Huang

doi:10.1055/a-2238-8399

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2024; 40(07): 504-510
DOI: 10.1055/a-2238-8399

Original Article

DIEP Donor Site Satisfaction between Patients with and without History of Pregnancy

David Chon-Fok Cheong

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan

²College of Medicine, Chang Gung University, Taoyuan, Taiwan

,

Allen Wei-Jiat Wong

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan

³Plastic Reconstructive and Aesthetic Service, Sengkang General Hospital, Singapore

,

Shu-Wei Kao

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan

,

Shu-Ying Chang

²College of Medicine, Chang Gung University, Taoyuan, Taiwan

⁴Division of General Plastic Surgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan

,

Jung-Ju Huang

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan

²College of Medicine, Chang Gung University, Taoyuan, Taiwan

› Author Affiliations

Abstract

Background With the success of free autologous breast reconstruction, the abdominal donor site is now an important consideration, especially in patients of childbearing age. In our institution, there are increasing patients who have successfully undergone the deep inferior epigastric artery perforator (DIEP) flap despite previous pregnancy. This study aims to answer questions on the effect of the donor site on pregnancy and vice versa.

Methods A retrospective cohort study was conducted to identify breast cancer patients who received a free DIEP flap for breast reconstruction from January 2018 to August 2020. Patients were allocated to two groups according to whether they had prior pregnancies with successful deliveries. Demographics, flap-related parameters, surgical outcomes on breast and abdomen, and patient-reported outcome (Breast-Q questionnaire) were analyzed. Patients were excluded if follow-up time was less than 1 year, or if there was incomplete medical records or Breast-Q replies.

Results Ninety-nine of 116 patients had had successful pregnancies with delivery, 17 of them remained nulliparous. No statistically significant differences existed between groups regarding demographic data, flap-related parameters, surgical outcomes on breast and abdomen. Nulliparous patients exhibited significantly lower score in physical well-being in the abdomen domain compared with delivery-experienced patients (62.1 vs. 73.4, p = 0.025). Significantly, nulliparous patients felt more tightness and pulling of the abdominal wall than the delivery-experienced patients (2.9 vs. 3.7; p = 0.05 and 3.5 vs. 4.0; p = 0.04).

Conclusion Free DIEP flap can be transferred safely in nulliparous patients despite a slight increase in abdominal tightness and abdominal pulling. Precise flap design and surgical approaches may help to minimize the abdominal discomfort especially on young, normal body mass index, and nonchildbearing patients.

Keywords

DIEP flap - breast reconstruction - donor site - young breast cancer - Breast-Q

Full Text

References

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