Obesity Affects DIEP Flap Outcomes and Donor Site Complications

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Presentation transcript:

Obesity Affects DIEP Flap Outcomes and Donor Site Complications Daniel J Womac MD, Micheal F Reynolds BS, Cyrus F Loghmanee MD, Dennis K Schimpf MD, Patrick J O’Neill MD Medical University of South Carolina Nothing to Disclose

Objective The purpose of this study is to determine if obesity, as determined by body mass index (BMI) is a predisposing factor leading to DIEP flap necrosis and/or donor site complications.

Materials and Methods A retrospective chart review of 92 patients who underwent DIEP flap reconstruction over a five year period was performed. Flap necrosis and donor site complications were evaluated and compared with BMI.

Materials and Methods Flap necrosis was divided into 4 groups; none, minimal, moderate, and complete. Donor site complications were considered as any wound breakdown, infection, or seroma requiring opening, drainage and secondary wound healing. Statistical analysis was performed.

Results A total of 161 flaps were performed. There were a total of 32/161 (19.88%) flap complications and 22/92 (23.9%) donor site complications. There were 8 complete flap losses (4.9%). The mean age was 52 years and mean BMI was 28.9.

Results The mean BMI for complete flap losses was 32.91+/- 2.77. There was a significant difference between the no flap loss and complete flap loss groups (28.37 ± 4.58 vs. 32.91 ± 2.77, p= 0.008) and between the minimal flap loss and complete flap loss groups (28.66 ± 4.67 vs. 32.91 ± 2.77, p= 0.026).

BMI and Flap Necrosis

Results There was a significant difference in BMI between the no donor site complication and donor site complication groups (28.34 ± 4.59 vs. 30.91 ± 4.79, p= 0.025).

Conclusions This study concludes a significant association between increasing BMI and complication rates. According to our results, as BMI increases, the risk of DIEP flap and donor site complications significantly increases.

Significance As obesity becomes more prevalent in the US, more women will be diagnosed with a later stage of breast cancer. These patients will have higher risk of complication after DIEP breast reconstruction. Therefore, this population should be counseled appropriately.