Incidence and significance of microscopic pathological lesions found in pedicle and recipient vessels used in microsurgical breast reconstruction

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dc.contributor.authorEl-Mrakby, H.
dc.contributor.authorMcLean, N.
dc.contributor.authorHodgkinson, P.
dc.contributor.authorSoames, J.
dc.date.issued2003
dc.description.abstractThe purpose of this study was to assess the incidence of abnormal vascular histology and to determine whether or not this was correlated with the incidence of postoperative microvascular problems. The microvascular histology of both donor and recipient vessels was studied in 38 patients (40 flaps) undergoing breast reconstruction with free TRAM flaps. Preoperative risk factors were assessed and correlated with histological changes in vessels, and both were tested against anastomotic complications. Thrombosis of either the artery or the vein of the flap was seen in 6 cases (15%), and of these, two flaps failed completely and one suffered partial necrosis. The occlusion affected the arterial anastomosis in 3 patients, and the venous anastomosis in 2 patients, while both the artery and the vein were thrombosed in one case. Preoperative risk factors such as smoking, obesity, radiotherapy, and chemotherapy were not associated with a significantly higher incidence of thrombosis or with significant histological abnormalities in vessels (P value varied between 0.3-0.06). Microvascular histology showed variable degrees of pathological changes in six flaps (15%); nevertheless, in this group, only one flap suffered a venous thrombosis, which ended in total flap loss. Among those with one or more risk factors (24 patients), only 2 had some evidence of histological abnormality of the blood vessels used for the microvascular anastomosis (P = 0.2).
dc.identifier.citationMicrosurgery, 2003; 23(1):1-4
dc.identifier.doi10.1002/micr.10085
dc.identifier.issn0738-1085
dc.identifier.issn1098-2752
dc.identifier.urihttp://hdl.handle.net/2440/10641
dc.language.isoen
dc.publisherWiley-Liss
dc.rights© 2003 Wiley-Liss, Inc.
dc.source.urihttps://doi.org/10.1002/micr.10085
dc.subjectMicrocirculation
dc.subjectSurgical Flaps
dc.subjectHumans
dc.subjectBreast Neoplasms
dc.subjectThrombosis
dc.subjectPostoperative Complications
dc.subjectPrognosis
dc.subjectMammaplasty
dc.subjectMicrosurgery
dc.subjectIncidence
dc.subjectMultivariate Analysis
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectChi-Square Distribution
dc.subjectCohort Studies
dc.subjectGraft Survival
dc.subjectRegional Blood Flow
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.titleIncidence and significance of microscopic pathological lesions found in pedicle and recipient vessels used in microsurgical breast reconstruction
dc.typeJournal article
pubs.publication-statusPublished

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