Archives of Plastic Surgery

  • 제41권5호
  • /
  • Pages.542-547
  • /
  • 2014
  • /
  • 2234-6163(pISSN)
  • /
  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
권호 표지
DOI QR코드

DOI QR Code

The Influence of Pfannenstiel Incision Scarring on Deep Inferior Epigastric Perforator

  • Park, Young Jin (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Eun Key (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yun, Ji Young (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Eom, Jin Sup (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Taik Jong (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2014.01.16
  • 심사 : 2014.03.12
  • 발행 : 2014.09.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.

키워드

참고문헌

  1. Lee JH, Yim SH, Won YJ, et al. Population-based breast cancer statistics in Korea during 1993-2002: incidence, mortality, and survival. J Korean Med Sci 2007;22 Suppl:S11-6. https://doi.org/10.3346/jkms.2007.22.S.S11
  2. Lee SI, Khang YH, Lee MS. Women's attitudes toward mode of delivery in South Korea: a society with high cesarean section rates. Birth 2004;31:108-16. https://doi.org/10.1111/j.0730-7659.2004.00288.x
  3. Lees DH. Opening and closing the abdomen. In: Lees DH, Singer A, editors. Color atlas of gynecological surgery, Vol. 2. London: Year Book Medical Publishers; 1989. p.15-42.
  4. Meeks GR. Clinical anatomy of incisions. In: Mann WJ, Stovall TG, editors. Gynecologic surgery. New York: Churchill Livingstone; 1996. p.121-68.
  5. Nichols DH, Clarke-Pearson DL. Gynecologic, obstetric, and related surgery. St. Louis: Mosby; 2000.
  6. Hartrampf CR Jr, Bennett GK. Autogenous tissue reconstruction in the mastectomy patient. A critical review of 300 patients. Ann Surg 1987;205:508-19. https://doi.org/10.1097/00000658-198705000-00009
  7. Watterson PA, Bostwick J 3rd, Hester TR Jr, et al. TRAM flap anatomy correlated with a 10-year clinical experience with 556 patients. Plast Reconstr Surg 1995;95:1185-94. https://doi.org/10.1097/00006534-199506000-00007
  8. Moon HK, Taylor GI. The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep superior epigastric system. Plast Reconstr Surg 1988;82:815-32. https://doi.org/10.1097/00006534-198811000-00014
  9. Takeishi M, Shaw WW, Ahn CY, et al. TRAM flaps in patients with abdominal scars. Plast Reconstr Surg 1997;99:713-22. https://doi.org/10.1097/00006534-199703000-00018
  10. Schusterman MA, Kroll SS, Weldon ME. Immediate breast reconstruction: why the free TRAM over the conventional TRAM flap? Plast Reconstr Surg 1992;90:255-61. https://doi.org/10.1097/00006534-199290020-00013
  11. Mahajan AL, Zeltzer A, Claes KE, et al. Are Pfannenstiel scars a boon or a curse for DIEP flap breast reconstructions? Plast Reconstr Surg 2012;129:797-805. https://doi.org/10.1097/PRS.0b013e3182450a8f
  12. Sozer SO, Cronin ED, Biggs TM, et al. The Use of the Transverse Rectus Abdominis Musculocutaneous Flap After Abdominoplasty. Annals of Plastic Surgery 1995;35.
  13. Ribuffo D, Marcellino M, Barnett GR, et al. Breast reconstruction with abdominal flaps after abdominoplasties. Plast Reconstr Surg 2001;108:1604-8. https://doi.org/10.1097/00006534-200111000-00026

피인용 문헌

  1. The Influence of Pfannenstiel Incision Scarring on Deep Inferior Epigastric Perforator vol.41, pp.5, 2014, https://doi.org/10.5999/aps.2014.41.5.548
  2. Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps vol.42, pp.6, 2014, https://doi.org/10.5999/aps.2015.42.6.741
  3. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps vol.43, pp.5, 2014, https://doi.org/10.5999/aps.2016.43.5.457
  4. The Influence of a Pfannenstiel Scar on Venous Anatomy of the Lower Abdominal Wall and Implications for Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction vol.139, pp.3, 2014, https://doi.org/10.1097/prs.0000000000003107
  5. The originating pattern of deep inferior epigastric artery: anatomical study and surgical considerations vol.40, pp.8, 2018, https://doi.org/10.1007/s00276-018-2055-8
  6. Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients vol.8, pp.5, 2014, https://doi.org/10.1002/cam4.2133