Evaluating Mastectomy Skin Flap Necrosis in the Extended Breast Reconstruction Risk Assessment Score for 1-Year Prediction of Prosthetic Reconstruction Outcomes

Journal of the American College of Surgeons
Nora M HansenJohn Y S Kim

Abstract

Rates of mastectomy for breast cancer treatment and immediate reconstruction continue to rise. With increasing scrutiny on outcomes and patient satisfaction, there is an impetus for providers to be more deliberate in appropriate patient selection for breast reconstruction. The Breast Reconstruction Risk Assessment (BRA) Score was developed for prediction of complications after primary prosthetic breast reconstruction, focusing on calculating risk estimations for a variety of complications based on individual patient demographic and perioperative characteristics. In this study, we evaluated mastectomy skin flap necrosis (MSFN) as a function of patient characteristics to validate the BRA Score. We examined our prospective intra-institutional database of prosthetic breast reconstructions from 2004 to 2015. The end point of interest was 1-year occurrence of MSFN after stage I tissue expander placement. Nine hundred and three patients were included; 50% underwent bilateral reconstruction. Median follow-up was 23 months. Mean 1-year complication rates were as follows: MSFN 12.4%, seroma 3.0%, infection 6.9%, dehiscence/exposure 7.1%, and explantation 13.2%. Statistically significantly higher rates of MSFN were found in older patients...Continue Reading

Citations

Jan 28, 2020·Plastic and Reconstructive Surgery·Jordan D FreyNolan S Karp
Dec 13, 2019·Journal of Cellular and Molecular Medicine·Yiwen ZhouQingfeng Li
Oct 24, 2020·Journal of Orthopaedic Surgery and Research·Jianmin XuYongliang Yang

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