Comparing the sensation of common donor site regions for autologous breast reconstruction to that of a healthy breast

Anouk J. M. Cornelissen, Jop Beugels, Arno Lataster, Esther M. Heuts, Shai M. Rozen, Aldona J. Spiegel, Rene R. W. J. van der Hulst, Stefania M. H. Tuinder*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: Autologous breast reconstruction has become the standard care for breast cancer patients. Although excellent cosmetic results can be achieved, most reconstructed breasts fail to regain normal sensation. Nerve coaptation of the flap has been suggested to improve sensation; the effect of the donor flap native sensory threshold on the degree of sensory restoration is yet to be determined. The aim of this study is to evaluate the differences in sensation between various potential donor site regions in comparison to the sensation of the healthy breast. Patients and methods: A cross-sectional study in healthy women was performed in the Maastricht University Medical Centre. Monofilaments were used to measure sensation in the breast and at different flap donor sites: deep inferior epigastric perforator (DIEP), lateral thigh perforator (LTP), profunda artery perforator (PAP), superior gluteal artery perforator (SGAP) and transverse musculocutaneous gracilis (TMG) flaps. The Wilcoxon signed rank test was used to analyse statistical significance in sensation. Results: Fifty women with a mean age of 49 +/- 2.72 years and mean BMI of 26.14 +/- 0.89 kg/m(2) were included in the study. The median monofilament value of the normal breasts was 2.97(2.56-3.55). The median monofilament value of each donor site and p value when compared to the healthy breast were as follows: DIEP flap, 2.62 (2.36-3.22) p < 0.01; LTP flap, 3.61 (2.83-4.08) p < 0.01; PAP flap, 3.09 (2.67-3.5) p = 0.97; SGAP flap, 3.22 (2.64-3.87) p = 0.01; and TMG flap, 3.03 (2.6-3.47) p = 0.69. Conclusions: There is a significant difference in sensation between the various donor site regions for breast reconstruction and the healthy breast. This may be taken into consideration for donor site selection. (C) 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)327-335
Number of pages9
JournalJournal of Plastic Reconstructive and Aesthetic Surgery
Volume71
Issue number3
DOIs
Publication statusPublished - 1 Mar 2018
EventCongress of World-Society-for-Reconstructive-Microsurgery (WSRM) - Seoul, SOUTH KOREA, Seoul
Duration: 1 Mar 2018 → …

Keywords

  • Breast reconstruction
  • Microsurgery
  • Nerve coaptation
  • Innervation
  • Sensation
  • Donor site
  • ARTERY PERFORATOR FLAP
  • SENSORY RECOVERY
  • SENSIBILITY
  • MAMMAPLASTY
  • THRESHOLDS
  • SUPERIOR

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