July 17, 2020
Does a history of abdominal surgery impact DIEP flap reconstruction outcomes?
Women who have had previous abdominal surgery are likely still candidates for bilateral DIEP flap breast reconstruction. But, do prior abdominal scars impact outcomes?
A recent study took a closer look at the impact of prior abdominal surgery scars on complication rates in bilateral abdominal flap breast reconstruction. The study concluded that surgical outcomes of bilateral abdominal reconstruction in patients with prior abdominal scars are “generally comparable with ones in patients without prior surgery”.
“Most of our patients have had prior abdominal surgery. Likewise, a large proportion of our patients elect for bilateral DIEP flap reconstruction. Prior abdominal surgery can affect the ability to use flaps from the abdomen, but we rarely see this occur in our practice,” says Dr. Gary Arishita. “For me, the biggest concern is whether we can perform a successful reconstruction with both flaps surviving and healthy. Upon the initial consultation with a patient, I listen to the perforators with a Doppler in the office. If the exam is abnormal, I will request a CT angiogram (CTA). At PRMA, we usually only recommend a pre-operative CTA in patients who have had multiple previous abdominal surgeries and there is a question about the perforator anatomy. Most of the time, the CT scan is very helpful for planning the surgery and ensuring we can harvest the flaps successfully.”
Patients undergoing DIEP flap breast reconstruction should know they have a slightly increased but “comparable” risk in terms of abdominal complications compared to patients that have never had abdominal surgery. However, with the exception of a previous full abdominoplasty, prior abdominal surgery is rarely a contraindication for the procedure in experienced hands; just because a patient has had previous abdominal surgery does not mean they are not a candidate for a DIEP flap. In addition, the chances of a successful outcome remains extremely high.
Author: Dr Gary Arishita and Courtney Floyd
Most of our patients have had prior abdominal surgery. Likewise, a large proportion of our patients elect for bilateral DIEP flap reconstruction. Prior abdominal surgery can affect the ability to use flaps from the abdomen, but we rarely see this occur in our practice.
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