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| Name | Class |
|---|---|
| Breast Imaging Division, Radiologie Augsburg Friedberg / Breast Center Augsburg, Augsburg, Germany | UNKNOWN |
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Exposure of internal mammary vessels in autologous breast reconstruction often requires removal of a rib cartilage segment, which can lead to contour deformity in the craniomedial breast pole. This study evaluated the use of diced cartilage (DC) to counteract substance loss in the microvascular anastomosis area, and investigated safety and suitability of the procedure to avoid postoperative deformities.
This retrospective, single-center cohort study included all breast reconstructions in which DC was used from October 2021 to June 2023. Reconstructions using DC were subdivided based on previous exposure to breast radiotherapy (DC vs. DCR). The control group consisted of an equal number of consecutive reconstructions performed prior to the use of DC. The effect of DC on breast contour preservation was investigated using breast magnetic resonance imaging (MRI; > 6 months post-op) and photographic documentation (6-month follow-up).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| diced cartilage (DC) | After removing a part of the rip cartilage and microsurgery, the exposed internal mammary vessels in autologous free flap breast reconstruction was restored with diced cartilage (DC) out of the removed rip cartialge. |
| |
| control | After removing a part of the rip cartilage and microsurgery, the exposed internal mammary vessels in autologous free flap breast reconstruction was NOT restored. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| diced cartilage | Procedure | In reconstructions using DC management of IMVES, the surgical nurse processed the removed cartilage into DC using a dermatome blade. Cartilage pieces of approximately 0,5-1 mm were used. After microvascular anastomosis (coupler device for venous anastomosis; Synovis MCA, Birmingham AL, USA), all DC was placed back into the rib removal zone using a blunt dissector. The vessels were embedded and stabilized in cartilage paste according to the desired orientation. |
| Measure | Description | Time Frame |
|---|---|---|
| Magnetic resonance imaging (MRI) scans: soft tissue sinking of the recipient vessels area | the sinking depth of epicostal soft tissue into the space of rib segment resection on axial planes in Magnetic resonance imaging (MRI) scans performed at least 6 months postoperatively | October 2021 to June 2023 |
| Measure | Description | Time Frame |
|---|---|---|
| Visual contour deficit of the recipient vessels area | Postoperative photographic images were examined by two investigators (blinded to group assignments) for IMVES-associated deformities using standardized photographic images of the reconstructed breasts at the 6-month follow-up. | October 2021 to June 2023 |
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Inclusion Criteria:
Exclusion Criteria:
The limitation of this study to the female gender is due to the phenotypic anatomical body structure and the intended reconstruction.
The study population consists of women who received autologous free flap breast reconstruction using internal mammary vessels as recipient vessels.
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| Name | Affiliation | Role |
|---|---|---|
| Ulf Dornseifer, MD/PhD | Head of Department plastic and reconstructive surgery ISAR Klinikum | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ISAR Klinikum - Department Plastic Surgery | Munich | Bavaria | 80331 | Germany | ||
| ISAR Klinikum |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 10, 2024 | Jul 10, 2024 | Prot_SAP_000.pdf |
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| Munich |
| Bavaria |
| 80331 |
| Germany |