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The purpose of this study was to perform a quantitative perfusion study of the undermined abdominal skin in deep inferior epigastric artery perforator flap breast reconstruction patients in order to obtain more knowledge on perfusion dynamics. Laser Doppler perfusion imaging (LDPI) was used to evaluate this.
Microcirculatory changes were monitored in the abdominal skin of 20 consecutive patients. Measurements were taken and recorded within four standardized zones covering the skin between the xiphoid process and the upper incisional boundary of the flap (zone 1-4; cranial to caudal).
Background: No studies have assessed the perfusion of the undermined abdominal skin in breast reconstruction with deep inferior epigastric artery perforator flap. A greater understanding of the procedure's impact on the perfusion of the abdominal skin can be valuable in predicting areas susceptible to necrosis.
Methods: Microcirculatory changes were monitored in the abdominal skin of 20 consecutive patients undergoing breast reconstruction with a deep inferior epigastric artery perforator flap. Quantitative mapping was performed with laser Doppler perfusion imaging at seven set intervals. Measurements were taken and recorded within four standardized zones covering the skin between the xiphoid process and the upper incisional boundary of the flap (zone 1-4; cranial to caudal).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Laser Doppler Perfusion Imaging | 20 consequetive cases undergoing breast reconstruction with Deep inferior epigastric artery perforator flap who had evaluation of the microcirculation of the abdominal skin with laser Doppler perfusion imaging |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laser Doppler perfusion imaging | Device | LDPI is an extension of laser Doppler flowmetry (LDF) and was developed to generate a colour-coded perfusion image in a large area of skin. |
| Measure | Description | Time Frame |
|---|---|---|
| Perfusion of the abdominal zones measured in mean perfusion units | Preoperative | |
| Perfusion of the abdominal zones measured in mean perfusion units | two hours (After raising the flap) | |
| Perfusion of the abdominal zones measured in mean perfusion units | Three hours (After undermining) | |
| Perfusion of the abdominal zones measured in mean perfusion units | Five hours (After abdominal closure) | |
| Perfusion of the abdominal zones measured in mean perfusion units | Postoperative day 1 (POD1) | |
| Perfusion of the abdominal zones measured in mean perfusion units | Postoperative day 3 (POD3) | |
| Perfusion of the abdominal zones measured in mean perfusion units | Postoperative day 7 (POD7) |
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Inclusion Criteria:
Exclusion Criteria:
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20 women consecutively undergoing secondary, unilateral breast reconstruction with a DIEAP flap were identified and recruited to participate in the study. The patients were informed about of risks and benefits and gave written consent prior to participation. All smokers stopped smoking 4 weeks prior to surgery.
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| Name | Affiliation | Role |
|---|---|---|
| Kim A Tønseth, MD, PhD | Oslo University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Plastic and Reconstructive Surgery | Oslo | Oslo | 0424 | Norway |
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