PDF(Pubmed)
Abstract：
UNASSIGNED: Perforator flaps have revolutionized autologous breast reconstruction, introducing both free and pedicled options as well as the potential for combining flaps. These versatile techniques can be utilized in massive weight loss (MWL) patients, effectively addressing both functional and aesthetic challenges by using their excess skin. This review aims to explore literature on combined pedicled and free perforator flaps for total breast reconstruction, and share our own experience in the field.
UNASSIGNED: A PubMed search up to June 2023 employed Medical Subject Headings (MeSH) terms such as ((\"combined\") OR (\"stacked\") OR (\"conjoined\") AND (\"perforator flaps\")) AND (\"breast reconstruction\"). Publications in English and Scandinavian languages were manually screened for relevance, and supplemental sources were also reviewed.
UNASSIGNED: Limited studies exist on using combined pedicled and free flaps for total breast reconstruction, although combined free flaps are more common. Perforators around the breast base, offer multiple flap options for single or combined use. In our series of 10 women, four underwent total breast reconstruction with a combination of flip-over internal mammary artery perforator (IMAP) flap and thoracodorsal artery perforator (TDAP) flap. Another subset of four, who were MWL patients, received combined TDAP and superior epigastric artery perforator (SEAP) flaps, along with body contouring procedures such as upper body lifts and vertical abdominoplasties, addressing excess skin and improving silhouette. One remaining MWL patient had deflated breasts restored using TDAP and SEAP flaps, along with an upper and lower body lift and vertical abdominoplasty. The last MWL patient underwent a risk-reducing mastectomy, also reconstructed with TDAP and SEAP flaps, and received an upper body lift and vertical abdominoplasty.
UNASSIGNED: Combined perforator flap techniques for combined body contouring and breast reconstruction seems safe and especially suitable for MWL patients. They offer a surgical alternative merging body contouring and breast reconstruction in cases where free flap procedures seem less favorable due to skin laxity and deflation of donor sites. However, limited literature on the topic calls for further studies.
UNASSIGNED: A PubMed search up to June 2023 employed Medical Subject Headings (MeSH) terms such as ((\"combined\") OR (\"stacked\") OR (\"conjoined\") AND (\"perforator flaps\")) AND (\"breast reconstruction\"). Publications in English and Scandinavian languages were manually screened for relevance, and supplemental sources were also reviewed.
UNASSIGNED: Limited studies exist on using combined pedicled and free flaps for total breast reconstruction, although combined free flaps are more common. Perforators around the breast base, offer multiple flap options for single or combined use. In our series of 10 women, four underwent total breast reconstruction with a combination of flip-over internal mammary artery perforator (IMAP) flap and thoracodorsal artery perforator (TDAP) flap. Another subset of four, who were MWL patients, received combined TDAP and superior epigastric artery perforator (SEAP) flaps, along with body contouring procedures such as upper body lifts and vertical abdominoplasties, addressing excess skin and improving silhouette. One remaining MWL patient had deflated breasts restored using TDAP and SEAP flaps, along with an upper and lower body lift and vertical abdominoplasty. The last MWL patient underwent a risk-reducing mastectomy, also reconstructed with TDAP and SEAP flaps, and received an upper body lift and vertical abdominoplasty.
UNASSIGNED: Combined perforator flap techniques for combined body contouring and breast reconstruction seems safe and especially suitable for MWL patients. They offer a surgical alternative merging body contouring and breast reconstruction in cases where free flap procedures seem less favorable due to skin laxity and deflation of donor sites. However, limited literature on the topic calls for further studies.
摘要：
■穿支皮瓣彻底改变了自体乳房重建，引入自由和带蒂的选项以及结合皮瓣的潜力。这些通用技术可用于大量减肥（MWL）患者，通过使用多余的皮肤有效地解决功能和美学挑战。这篇综述旨在探索有关带蒂和游离穿支皮瓣联合用于全乳房重建的文献。并分享我们在该领域的经验。
■截至2023年6月的PubMed搜索使用医学主题词（MeSH）术语，例如（（\“组合\”）或（\“堆叠\”）或（\“连体\”）和（\“穿孔器皮瓣\”）和（\“乳房重建\”）。英文和斯堪的纳维亚语言的出版物进行了人工筛选，以确定其相关性，和补充来源也进行了审查。
■关于使用带蒂和游离联合皮瓣进行全乳房重建的研究有限，虽然组合式自由皮瓣更为常见。乳房底部周围的穿孔器，提供单一或组合使用多个皮瓣选项。在我们的10个女人系列中，4例患者采用翻转式乳内动脉穿支(IMAP)皮瓣和胸背动脉穿支(TDAP)皮瓣联合进行全乳房再造.四个的另一个子集，MWL患者，接受TDAP和腹壁上动脉穿支（SEAP）联合皮瓣，随着身体轮廓的程序，如上身提升和垂直腹部成形术，解决多余的皮肤和改善轮廓。剩下的一名MWL患者使用TDAP和SEAP皮瓣恢复了放气的乳房，以及上下身体提升和垂直腹部成形术。最后一名MWL患者接受了降低风险的乳房切除术，还用TDAP和SEAP襟翼重建，并接受了上身提升和垂直腹部成形术。
■用于组合身体轮廓和乳房重建的组合穿支皮瓣技术似乎是安全的，尤其适用于MWL患者。在由于皮肤松弛和供体部位放气而游离皮瓣手术似乎不太有利的情况下，它们提供了一种手术替代方法，可以合并身体轮廓和乳房重建。然而,关于这个主题的有限文献需要进一步研究。
■截至2023年6月的PubMed搜索使用医学主题词（MeSH）术语，例如（（\“组合\”）或（\“堆叠\”）或（\“连体\”）和（\“穿孔器皮瓣\”）和（\“乳房重建\”）。英文和斯堪的纳维亚语言的出版物进行了人工筛选，以确定其相关性，和补充来源也进行了审查。
■关于使用带蒂和游离联合皮瓣进行全乳房重建的研究有限，虽然组合式自由皮瓣更为常见。乳房底部周围的穿孔器，提供单一或组合使用多个皮瓣选项。在我们的10个女人系列中，4例患者采用翻转式乳内动脉穿支(IMAP)皮瓣和胸背动脉穿支(TDAP)皮瓣联合进行全乳房再造.四个的另一个子集，MWL患者，接受TDAP和腹壁上动脉穿支（SEAP）联合皮瓣，随着身体轮廓的程序，如上身提升和垂直腹部成形术，解决多余的皮肤和改善轮廓。剩下的一名MWL患者使用TDAP和SEAP皮瓣恢复了放气的乳房，以及上下身体提升和垂直腹部成形术。最后一名MWL患者接受了降低风险的乳房切除术，还用TDAP和SEAP襟翼重建，并接受了上身提升和垂直腹部成形术。
■用于组合身体轮廓和乳房重建的组合穿支皮瓣技术似乎是安全的，尤其适用于MWL患者。在由于皮肤松弛和供体部位放气而游离皮瓣手术似乎不太有利的情况下，它们提供了一种手术替代方法，可以合并身体轮廓和乳房重建。然而,关于这个主题的有限文献需要进一步研究。
