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Obesity Affects DIEP Flap Outcomes and Donor Site Complications

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.

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Obesity Affects DIEP Flap Outcomes and Donor Site Complications

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  1. 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 MDMedical University of South CarolinaNothing to Disclose

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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).

  7. BMI and Flap Necrosis

  8. 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).

  9. 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.

  10. 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.

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