乳房再建における側cost間動脈穿孔器フラップ：単純化された椎弓根により、役割の拡大が可能になります

BACKGROUND: The lateral intercostal artery perforator (LICAP) flap is a versatile second-tier option in breast reconstruction. The flap is rotated from redundant lateral chest fold on an easily dissected skin bridge pedicle without microsurgery in an outpatient setting. This series illustrates safety and effectiveness of the LICAP flap for prosthesis coverage when a muscle flap is not available or desired. In some cases, it even provides adequate soft tissue to reconstruct the breast mound without an implant. 方法：外来局間穿孔器穿孔器フラップは、外来手術センターで乳房再建のために行われたフラップをレビューしました。 RESULTS: A total of 39 flaps were performed on an outpatient basis for a variety of breast reconstruction indications.乳房切除術後、両側のLICAPフラップによる即時の再建が行われました。残りのフラップはすべて、乳房の再建が遅れるためでした。各フラップの平均手術時間は65分であり、27人の患者のうち25人で併用手順が実施されました。Follow-up was 5 to 96 months.There was 1 major complication (2.5%) and 5 minor (12.8%) complications. 結論：このシリーズは、外来患者の設定、筋肉の犠牲、フラップの信頼性、低いドナー部位の罹患率など、さまざまな乳房再建の問題に対するLICAPフラップのユニークな利点を示しています。これらの結果は、LICAPフラップが放射線後でも罹患率が最小限で、外側胸部の冗長組織から大きな皮膚/脂肪フラップを確実に供給するという肥満後の増強における以前の報告を確認します。LICAPフラップは、乳房再建において綿密な検討を保証します。

BACKGROUND: The lateral intercostal artery perforator (LICAP) flap is a versatile second-tier option in breast reconstruction. The flap is rotated from redundant lateral chest fold on an easily dissected skin bridge pedicle without microsurgery in an outpatient setting. This series illustrates safety and effectiveness of the LICAP flap for prosthesis coverage when a muscle flap is not available or desired. In some cases, it even provides adequate soft tissue to reconstruct the breast mound without an implant. METHODS: Lateral intercostal artery perforator flaps performed for breast reconstruction at an ambulatory surgery center were reviewed. RESULTS: A total of 39 flaps were performed on an outpatient basis for a variety of breast reconstruction indications. One immediate reconstruction with bilateral LICAP flaps was performed after mastectomy. All remaining flaps were for delayed breast reconstruction. Mean operative time for each flap was 65 minutes, and concomitant procedures were performed in 25 of 27 patients. Follow-up was 5 to 96 months. There was 1 major complication (2.5%) and 5 minor (12.8%) complications. CONCLUSIONS: This series demonstrates unique advantages of the LICAP flap for a variety of breast reconstruction problems, including outpatient setting, no muscle sacrifice, flap reliability, and low donor site morbidity. These results confirm previous reports in post bariatric augmentation that the LICAP flap reliably supplies a large skin/adipose flap from the redundant tissue of the lateral chest fold with minimal morbidity even after radiation. The LICAP flap warrants closer consideration in breast reconstruction.