Pedicled Perforator Flap – A District General Hospital’s Experience
Association of Breast Surgery ePoster Library. Bromley G. 05/13/19; 257200; P158
Ms. Gwen Bromley
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P158
Topic: Surgical techniques
IntroductionLocal flap volume replacement techniques may be used in patients undergoing breast conservation surgery, in whom volume displacement techniques and therapeutic mammoplasty are inappropriate. In these cases, defects of up to 150g can be adequately filled by mobilising pedicled intercostal artery perforator flaps. Here, we review our results since introducing a local flap service in a high-volume breast screening unit 22 months ago.MethodHospital coding records for “perforator flap” were searched and cross-referenced with patient notes. Data recorded included age, BMI, smoking status, tumour size, type of flap, complications and any further surgery or delays to adjuvant treatment. Results: A total of 19 patients were included in the study. The median age was 56, the average BMI was 27.5. 16% were smokers. 89% (n=17) of flaps were performed in the immediate setting. The average tumour size was 38mm (range 17-100mm) and 68% had SLNB. The most common flaps were LICAP (n=9, 47%) and MICAP (n=7, 37%). 52% of procedures were performed as a day case. 74% (n=14) of patients had no complications or further procedures. One patient developed wound breakdown requiring re-operation. Two patients had positive margins requiring completion mastectomy. There were no delays to adjuvant treatment. Conclusions: The introduction of a local flap volume replacement service, using perforator flaps, has allowed breast conservation surgery with few complications, in patients where tissue displacement techniques or therapeutic mammoplasty would not be appropriate.
Topic: Surgical techniques
IntroductionLocal flap volume replacement techniques may be used in patients undergoing breast conservation surgery, in whom volume displacement techniques and therapeutic mammoplasty are inappropriate. In these cases, defects of up to 150g can be adequately filled by mobilising pedicled intercostal artery perforator flaps. Here, we review our results since introducing a local flap service in a high-volume breast screening unit 22 months ago.MethodHospital coding records for “perforator flap” were searched and cross-referenced with patient notes. Data recorded included age, BMI, smoking status, tumour size, type of flap, complications and any further surgery or delays to adjuvant treatment. Results: A total of 19 patients were included in the study. The median age was 56, the average BMI was 27.5. 16% were smokers. 89% (n=17) of flaps were performed in the immediate setting. The average tumour size was 38mm (range 17-100mm) and 68% had SLNB. The most common flaps were LICAP (n=9, 47%) and MICAP (n=7, 37%). 52% of procedures were performed as a day case. 74% (n=14) of patients had no complications or further procedures. One patient developed wound breakdown requiring re-operation. Two patients had positive margins requiring completion mastectomy. There were no delays to adjuvant treatment. Conclusions: The introduction of a local flap volume replacement service, using perforator flaps, has allowed breast conservation surgery with few complications, in patients where tissue displacement techniques or therapeutic mammoplasty would not be appropriate.
P158
Topic: Surgical techniques
IntroductionLocal flap volume replacement techniques may be used in patients undergoing breast conservation surgery, in whom volume displacement techniques and therapeutic mammoplasty are inappropriate. In these cases, defects of up to 150g can be adequately filled by mobilising pedicled intercostal artery perforator flaps. Here, we review our results since introducing a local flap service in a high-volume breast screening unit 22 months ago.MethodHospital coding records for “perforator flap” were searched and cross-referenced with patient notes. Data recorded included age, BMI, smoking status, tumour size, type of flap, complications and any further surgery or delays to adjuvant treatment. Results: A total of 19 patients were included in the study. The median age was 56, the average BMI was 27.5. 16% were smokers. 89% (n=17) of flaps were performed in the immediate setting. The average tumour size was 38mm (range 17-100mm) and 68% had SLNB. The most common flaps were LICAP (n=9, 47%) and MICAP (n=7, 37%). 52% of procedures were performed as a day case. 74% (n=14) of patients had no complications or further procedures. One patient developed wound breakdown requiring re-operation. Two patients had positive margins requiring completion mastectomy. There were no delays to adjuvant treatment. Conclusions: The introduction of a local flap volume replacement service, using perforator flaps, has allowed breast conservation surgery with few complications, in patients where tissue displacement techniques or therapeutic mammoplasty would not be appropriate.
Topic: Surgical techniques
IntroductionLocal flap volume replacement techniques may be used in patients undergoing breast conservation surgery, in whom volume displacement techniques and therapeutic mammoplasty are inappropriate. In these cases, defects of up to 150g can be adequately filled by mobilising pedicled intercostal artery perforator flaps. Here, we review our results since introducing a local flap service in a high-volume breast screening unit 22 months ago.MethodHospital coding records for “perforator flap” were searched and cross-referenced with patient notes. Data recorded included age, BMI, smoking status, tumour size, type of flap, complications and any further surgery or delays to adjuvant treatment. Results: A total of 19 patients were included in the study. The median age was 56, the average BMI was 27.5. 16% were smokers. 89% (n=17) of flaps were performed in the immediate setting. The average tumour size was 38mm (range 17-100mm) and 68% had SLNB. The most common flaps were LICAP (n=9, 47%) and MICAP (n=7, 37%). 52% of procedures were performed as a day case. 74% (n=14) of patients had no complications or further procedures. One patient developed wound breakdown requiring re-operation. Two patients had positive margins requiring completion mastectomy. There were no delays to adjuvant treatment. Conclusions: The introduction of a local flap volume replacement service, using perforator flaps, has allowed breast conservation surgery with few complications, in patients where tissue displacement techniques or therapeutic mammoplasty would not be appropriate.
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