Breaking News
February 22, 2019 - Successful testing of multi-organ “human-on-a-chip” could replace animals as test subjects
February 22, 2019 - Analysis of cervical precancer shows decline in two strains of HPV
February 22, 2019 - Sugary stent eases suturing of blood vessels
February 22, 2019 - From surgery to psychiatry: A medical student reevaluates his motivations
February 22, 2019 - Is New App From Feds Your Answer To Navigating Medicare Coverage? Yes And No
February 22, 2019 - New pacemakers powered by heartbeats could reduce need for surgery
February 22, 2019 - The United States records highest drug overdose death rates
February 22, 2019 - Phase 1 data reinforce safety profile of new drug for treating Duchenne muscular dystrophy
February 22, 2019 - Vitamin D supplementation less effective in the presence of obesity, shows study
February 22, 2019 - Sarepta Announces FDA Acceptance of Golodirsen (SRP-4053) New Drug Application for Patients with Duchenne Muscular Dystrophy Amenable to Skipping Exon 53
February 22, 2019 - An institutional effort to reduce the amount of opioids prescribed following lumbar surgery
February 22, 2019 - Failure to take statins leads to higher mortality rates | News Center
February 22, 2019 - New study explains why some patients report phantom sensations after limb amputation
February 22, 2019 - First motor-controlled heart valves implanted by Mainz University Medical Center
February 22, 2019 - Novel preclinical model mimics persistent interneuron loss seen in preterm infants
February 22, 2019 - Global health burden of glaucoma has increased, study reveals
February 22, 2019 - A holistic approach key to minimize treatment complexity in patients with interstitial lung disease
February 22, 2019 - 1 in 10 middle-aged Chinese adults are at high risk for heart disease, finds study
February 22, 2019 - More than half a million breast cancer patient’s lives saved by improvements in treatment
February 22, 2019 - Study finds no evidence that tougher policies prevent teenage cannabis use
February 22, 2019 - New blood test detects genetic disorders in fetuses
February 22, 2019 - Lower Self-Perception Observed in Children With Amblyopia
February 22, 2019 - Up to 15 percent of children have sleep apnea, yet 90 percent go undiagnosed
February 22, 2019 - Rare pulmonary defect prompts parents’ nationwide search for answers | News Center
February 22, 2019 - Lesbian and bisexual women at greater risk of being overweight, study finds
February 22, 2019 - UQ research may explain why vitamin D is essential for brain health
February 22, 2019 - Heart Attacks Rising Among Younger Women
February 22, 2019 - How your smartphone is affecting your relationship
February 22, 2019 - Orthopaedic surgeon receives prestigious award, $10 million grant | News Center
February 22, 2019 - New sepsis test could save thousands of lives
February 22, 2019 - Cervical cancer could be eradicated by 2100
February 21, 2019 - Sustained smoking cessation can lower risk of seropositive RA
February 21, 2019 - Thousands with chronic UTIs are not receiving the treatment they need
February 21, 2019 - Are teens getting high on social media? The surprising study seeking the pot-Instagram link
February 21, 2019 - Stanford expands biobank services | News Center
February 21, 2019 - Scientists identify link between drinking contexts and early onset intoxication among adolescents
February 21, 2019 - Strong social support may reduce cardiovascular disease risk in postmenopausal women
February 21, 2019 - Rapid expansion of interventions could prevent up to 13 million cases of cervical cancer within 50 years
February 21, 2019 - Motif Bio Receives Complete Response Letter From The FDA
February 21, 2019 - Researchers map previously unknown disease in children
February 21, 2019 - A skeptical look at popular diets: Going gluten-free
February 21, 2019 - Podcast: KHN’s ‘What The Health?’ How Safe Are Your Supplements?
February 21, 2019 - Factors associated with increased risk of developing surgical site infections
February 21, 2019 - Anticipatory signals in eye movements can help measure attentive capacity, learning with greater precision
February 21, 2019 - Study explores daily exposure to indoor air pollutants
February 21, 2019 - Evening exercise does not negatively affect sleep, may also reduce hunger
February 21, 2019 - Artificial intelligence technique can be used to identify alcohol misuse in trauma setting
February 21, 2019 - Overweight, obesity in adolescence associated with increased risk of renal cancer later in life
February 21, 2019 - BGU develops new AI platform for monitoring and predicting ALS progression
February 21, 2019 - Researchers discover a new promising target to improve HIV vaccines
February 21, 2019 - Brief Anesthesia in Infancy Does Not Mar Neurodevelopment
February 21, 2019 - Gaming system helps with autism diagnosis
February 21, 2019 - Heart Disease: Six Things Women Should Know
February 21, 2019 - More States Say Doctors Must Offer Overdose Reversal Drug Along With Opioids
February 21, 2019 - Researchers explore case studies focused on industries that kill more people than employed
February 21, 2019 - Only half of GP practice buildings are fit for purpose
February 21, 2019 - Intense exercise, fasting and hormones can enhance waste-protein removal, study shows
February 21, 2019 - Scientists can monitor brain activity to predict epileptic seizures few minutes in advance
February 21, 2019 - Study quantifies hepatic and intestinal mRNA expression of Ugt isoforms in rats
February 21, 2019 - ‘Apple-Shaped’ Body? ‘Pear-Shaped’? Your Genes May Tell
February 21, 2019 - Can we repair the brain? The promise of stem cell technologies for treating Parkinson’s disease
February 21, 2019 - Trump Plan To Beat HIV Hits Rough Road In Rural America
February 21, 2019 - PENTAX Medical introduces new electrosurgical and argon plasma coagulation platforms
February 21, 2019 - Trump plan to beat HIV hits rough road in rural America
February 21, 2019 - Eating blueberries every day could help decrease blood pressure
February 21, 2019 - ‘No Second Chances’ report calls for new measures to combat cardiovascular disease in Australia
February 21, 2019 - Mayo clinic researchers discuss local case studies of leprosy
February 21, 2019 - Scientists demonstrate key role of salt in allergic immune reactions
February 21, 2019 - Experts propose revising the criteria for diagnosis of Parkinson’s disease
February 21, 2019 - The med student and the machine
February 21, 2019 - Hey, Hey! Ho, Ho! Is Striking For School Nurses The Way To Go?
February 21, 2019 - Latest research encourages children to move out and learn through physical activity
February 21, 2019 - Proper oral hygiene and regular visits to dentist can promote heart health
February 21, 2019 - New, versatile technique for remote control of transplanted cells in Parkinson’s
February 21, 2019 - Why melanoma tumors in the brain may be worse?
February 21, 2019 - New project aims to improve lung disease care in Appalachia
February 21, 2019 - Drug increases melanin production in some people with albinism
February 21, 2019 - Over 1 in 3 adults miss the mark on protein, finds study
February 21, 2019 - CymaBay Therapeutics Announces Seladelpar Granted Breakthrough Therapy Designation by the FDA for the Treatment of Primary Biliary Cholangitis
February 21, 2019 - A correlation between obesity and income has only developed in the past 30 years
Free-flap reconstruction has “generally good outcomes” in women aged 65 or older

Free-flap reconstruction has “generally good outcomes” in women aged 65 or older

image_pdfDownload PDFimage_print

Breast reconstruction using a “free flap” from the patient’s abdomen is a safe procedure with a high success rate in older women opting for reconstruction after mastectomy, reports a study in the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Although the risk of some complications is higher, free-flap reconstruction has “generally good outcomes” in women aged 65 or older, according to the report by ASPS Member Surgeon Oren Tessler, MD, MBA, and colleagues of Louisiana State University Health Sciences Center, New Orleans. “Older women desire breast reconstruction after mastectomy, and should be offered all reconstruction options available,” Dr. Tessler comments.

Patient’s Health, Not Just Age, Affects Results of DIEP Flap Reconstruction

The researchers analyzed their experience with one type of free flap (deep inferior epigastric artery perforator, or “DIEP” flap) for breast reconstruction after mastectomy, comparing the outcomes in older versus younger women. Free flaps are an autologous reconstructive procedure, meaning that they use the patient’s own tissues (rather than implants). The DIEP flap uses tissue from the patient’s abdomen.

The study included data on DIEP flap reconstruction of 339 breasts in 208 patients after mastectomy for breast cancer between 2009 and 2013. Complications and risk factors were compared in a group of older women (average age 67 years, 54 flaps) versus younger women (average age 49 years, 285 flaps). The older women had substantially higher rates of medical risk factors, including diabetes, high blood pressure, and high cholesterol.

The primary outcome – complete or partial loss of the DIEP flap or the need for further flap surgery – was not significantly different between the older and younger groups. Dehiscence, a type of wound-healing complication, was more common in the older group: nearly 26 percent, compared to eight percent in the younger group. Complications related to the flap donor site in the abdomen were similar between age groups.

After adjustment for other factors – including the higher rate of medical risks in older women – age was a significant risk factor for complete flap loss as well as wound dehiscence. However, the absolute risk of complete flap loss was very low: only three cases (two in the older group, one in the younger) in a total of 339 DIEP flaps. Dr. Tessler comments, “The overall success rate in our older DIEP flap cases was 96.3 percent – only marginally lower than the 99.6 percent rate in our younger cases.”

Breast cancer is primarily a disease of older women: the median age at diagnosis is 62 years, and more than 40 percent of patients are 65 or older. Although breast reconstruction has important benefits after mastectomy, older women are less likely to undergo this procedure. Surgeons may perceive that breast reconstruction is riskier in older women, with higher rates of complications and wound healing problems.

While the new study does show that age 65 or older is associated with some increased risks after breast reconstruction. However, these complications appear at least partly related to the higher rates of medical risk factors among older women. The findings reinforce the importance of assessing the individual patient’s health status – not just age alone – in determining the risks of breast reconstruction.

Previous studies have suggested that older women undergoing mastectomy do want breast reconstruction, and that the benefits are similar to those in younger patients. “Therefore, we as plastic surgeons must be prepared to consult elderly patients before their mastectomies and be prepared to plan reconstructions in similar fashion to younger patients,” Dr. Tessler and coauthors write.

They conclude, “Although there is an increased risk of flap loss with age, patients 65 years and older can be advised that free flap reconstruction carries an acceptable risk profile in comparison to benefits of the procedure.”

Source:

https://wolterskluwer.com/

Tagged with:

About author

Related Articles