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. 2022 Feb 15:9:729181.
doi: 10.3389/fsurg.2022.729181. eCollection 2022.

Patient Management Strategies in Perioperative, Intraoperative, and Postoperative Period in Breast Reconstruction With DIEP-Flap: Clinical Recommendations

Kuo Chen  1 , Narasimha M Beeraka  2   3 , Mikhail Y Sinelnikov  2 , Jin Zhang  2 , Dajiang Song  4 , Yuanting Gu  1 , Jingruo Li  1 , I V Reshetov  2   5   6 , O I Startseva  2 , Junqi Liu  7 , Ruitai Fan  7 , Pengwei Lu  1
Affiliations

Patient Management Strategies in Perioperative, Intraoperative, and Postoperative Period in Breast Reconstruction With DIEP-Flap: Clinical Recommendations

Kuo Chen et al. Front Surg. .

Abstract

Background and objective: Deep Inferior Epigastric Perforator (DIEP) flap is a tissue isolated from the skin and subcutaneous tissue of the lower abdomen or rectus muscle to foster breast reconstruction. There is limited information about DIEP-flap induced complications associated with breast reconstruction surgery.

Evidence: We conducted a systematic review of the published literature in the field of breast cancer reconstruction surgery. Information was gathered through internet resources such as PubMed, Medline, eMedicine, NLM, and ReleMed etc. The following key phrases were used for effective literature collection: "DIEP flap", "Breast reconstruction", "Patient management", "Postoperative DIEP", "Intraoperative anticoagulant therapy", "Clinical recommendations". A total of 106 research papers were retrieved pertaining to this systematic review.

Conclusion: A successful breast reconstruction with DIEP-flap without complications is the priority achievement for this surgical procedure. This study provides various evidence-based recommendations on patient management in the perioperative, intraoperative, and postoperative periods. The clinical recommendations provided in this review can benefit surgeons to execute breast reconstruction surgery with minimal postoperative complications. These recommendations are beneficial to improve clinical outcomes when performing surgery by minimizing complications in perioperative, intraoperative, and postoperative period.

Keywords: DIEP flap; breast reconstruction; intraoperative; patient management; perioperative; postoperative period; surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Depiction of exclusion and inclusion criteria of patients who were undergone breast reconstruction and total 106 papers were primarily screened with respect to actuality, publication date, access to article text, content, number of patients, and complete flap-loss rate. Primary screening was executed and selected 56 research papers for secondary screening. Consequently, a two-stage screening process was performed and selected 21 research papers for this study.
Figure 2
Figure 2
Three main groups were chosen for proper categorization for further inferences to delineate the efficient patient management in preoperative period during DIEP flap-based breast reconstruction. This categorization was performed according to the preoperative preparation, postoperative patient management, and choice of the intraoperative therapy.
See this image and copyright information in PMC

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References

    1. Hofer SO, Damen TH, Mureau MA, Rakhorst HA, Roche NA. A critical review of perioperative complications in 175 free deep inferior epigastric perforator flap breast reconstructions. Ann Plast Surg. (2007) 59:137–42. 10.1097/01.sap.0000253326.85829.45 - DOI - PubMed
    1. Chen K, Lu P, Beeraka NM, Sukocheva OA, Madhunapantula SV, Liu J, et al. . Mitochondrial mutations and mitoepigenetics: focus on regulation of oxidative stress-induced responses in breast cancers. In: Seminars in Cancer Biology. (2020). 10.1016/j.semcancer.2020.09.012 - DOI - PubMed
    1. Blondeel PN, Vanderstraeten G, Monstrey S, Van Landuyt K, Tonnard P, Lysens R, et al. . The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction. Br J Plast Surg. (1997) 50:322–30. 10.1016/S0007-1226(97)90540-3 - DOI - PubMed
    1. Geddes CR, Morris SF, Neligan PC. Perforator flaps: evolution, classification, and applications. Ann Plast Surg. (2003) 50:90–9. 10.1097/00000637-200301000-00016 - DOI - PubMed
    1. Dancey A, Blondeel PN. Technical tips for safe perforator vessel dissection applicable to all perforator flaps. Clin Plast Surg. (2010) 37:593–606. 10.1016/j.cps.2010.06.008 - DOI - PubMed

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