Sensory recovery of the breast after innervated and non-innervated autologous breast reconstructions: A systematic review

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Abstract

Background: The sensory recovery of the reconstructed breast is an undervalued topic in the field of autologous breast reconstruction. This systematic review aimed to evaluate the available literature on the sensory recovery of the breast after innervated and non-innervated autologous breast reconstructions and to assess the possible benefits of sensory nerve coaptation compared to spontaneous reinnervation of the flap.

Methods: A comprehensive literature search was conducted in PubMed, Embase and the Co-chrane Library to identify all eligible studies regarding the sensory recovery of all types of innervated and non-innervated autologous breast reconstructions.

Results: The search yielded 334 hits, of which 32 studies concerning 1177 breast reconstructions were included. The amount of heterogeneity between the studies was high, which made the pooling of data difficult. The studies indicated that spontaneous reinnervation of autologous breast reconstructions occurred to a variable extent, depending on how and when it was measured. Despite these variable results, the sensory recovery of innervated flaps, however, was superior, started earlier and gradually improved over time with a higher chance of approaching normal values than non-innervated flaps. There is a lack of studies that assess the return of erogenous sensation and quality of life.

Conclusion: The current evidence shows that nerve coaptation results in superior sensory recovery of the reconstructed breast compared to spontaneous reinnervation of the flap. This review illustrates that more standardised, high-quality studies with adequate sample sizes are needed to objectively evaluate the sensory recovery of the breast after autologous breast reconstructions. (C) 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)1229-1241
Number of pages13
JournalJournal of Plastic Reconstructive and Aesthetic Surgery
Volume70
Issue number9
DOIs
Publication statusPublished - Sep 2017

Keywords

  • Breast reconstruction
  • Sensory recovery
  • Breast sensation
  • Nerve coaptation
  • FREE TRAM FLAP
  • INFERIOR EPIGASTRIC PERFORATOR
  • ABDOMINIS MYOCUTANEOUS FLAP
  • SKIN-SPARING MASTECTOMY
  • NIPPLE-AREOLA COMPLEX
  • DIEP-FLAP
  • SPONTANEOUS REINNERVATION
  • MUSCULOCUTANEOUS FLAPS
  • PATIENT SATISFACTION
  • SENSIBILITY

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