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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Ischaemic time and fat necrosis in breast reconstruction with a free deep inferior epigastric perforator flap
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Ischaemic time and fat necrosis in breast reconstruction with a free deep inferior epigastric perforator flap

机译：游离深部下腹上肌穿支皮瓣重建乳房的缺血性时间和脂肪坏死

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Purpose: Fat tissue can be injured by ischaemia in free flap surgeries, leading to the development of fat necrosis. The aim of this study was to evaluate the association between ischaemic time and fat necrosis in microsurgical breast reconstruction using a deep inferior epigastric perforator (DIEP) flap. Methods: A retrospective chart review was performed for patients who underwent breast reconstruction with free DIEP flaps between June 2009 and November 2011. Data regarding patient demographics, potential risk factors and fat necrosis were collected. Fat necrosis was diagnosed with ultrasound imaging between 3 and 6 months postoperatively. Univariate and multivariate analyses were used to assess the correlation between ischaemic time and fat necrosis rate. Receiver operating characteristic curve analysis was used to determine a cut-off value for the ischaemic time at which differential fat necrosis rates were maximal. Results: A total of 86 patients were included in this study. The mean ischaemic time was 89 min, and fat necrosis was diagnosed in 15 patients (17.4%). A significant association was found between ischaemic time and fat necrosis rate on univariate (p-value = 0.001) and multivariate analyses (p-value = 0.017). The trend analysis of ischaemic time as a categorical variable relative to fat necrosis rate was also significant (p-value <0.001). A threshold value was found whereby patients with an ischaemic time longer than 99.5 min appeared to experience a significantly higher fat necrosis rate than patients with shorter times (p-value = 0.005, odds ratio = 9.449). Conclusion: Ischaemic time appears to be significantly associated with increased fat necrosis rate in breast reconstruction using DIEP flaps. A long ischaemia time may be a risk factor for the development of fat necrosis.
机译：目的：在游离皮瓣手术中，缺血可损伤脂肪组织，导致脂肪坏死的发展。这项研究的目的是评估深部上腹穿孔（DIEP）皮瓣在显微外科乳房重建术中缺血时间与脂肪坏死之间的关系。方法：对2009年6月至2011年11月间使用游离DIEP皮瓣进行乳房再造的患者进行回顾性图表审查。收集有关患者人口统计学，潜在危险因素和脂肪坏死的数据。术后3至6个月通过超声显像诊断出脂肪坏死。单因素和多因素分析用于评估缺血时间和脂肪坏死率之间的相关性。接受者操作特征曲线分析用于确定缺血时间的临界值，在该临界时间，差异性脂肪坏死率最大。结果：本研究共纳入86例患者。平均缺血时间为89分钟，在15例患者中诊断出脂肪坏死（17.4％）。在单变量（p值= 0.001）和多变量分析（p值= 0.017）上，缺血时间和脂肪坏死率之间存在显着相关性。缺血时间作为相对于脂肪坏死率的分类变量的趋势分析也很显着（p值<0.001）。发现了一个阈值，缺血时间长于99.5分钟的患者似乎比短时间的患者经历明显更高的脂肪坏死率（p值= 0.005，优势比= 9.449）。结论：使用DIEP皮瓣重建乳房，缺血时间似乎与脂肪坏死率增加显着相关。长时间的缺血可能是导致脂肪坏死的危险因素。

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