Microcirculation of the Abdominal Skin After Deep Inferior Epigastric Artery Perforator Flap Procedure

Study Overview
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Brief Summary
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The purpose of this study was to perform a quantitative perfusion study of the undermined abdominal skin in deep inferior epigastric artery perforator flap breast reconstruction patients in order to obtain more knowledge on perfusion dynamics. Laser Doppler perfusion imaging (LDPI) was used to evaluate this. Microcirculatory changes were monitored in the abdominal skin of 20 consecutive patients. Measurements were taken and recorded within four standardized zones covering the skin between the xiphoid process and the upper incisional boundary of the flap (zone 1-4; cranial to caudal).

Detailed Description
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Background: No studies have assessed the perfusion of the undermined abdominal skin in breast reconstruction with deep inferior epigastric artery perforator flap. A greater understanding of the procedure's impact on the perfusion of the abdominal skin can be valuable in predicting areas susceptible to necrosis. Methods: Microcirculatory changes were monitored in the abdominal skin of 20 consecutive patients undergoing breast reconstruction with a deep inferior epigastric artery perforator flap. Quantitative mapping was performed with laser Doppler perfusion imaging at seven set intervals. Measurements were taken and recorded within four standardized zones covering the skin between the xiphoid process and the upper incisional boundary of the flap (zone 1-4; cranial to caudal).

Official Title
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Microcirculatory Evaluation of the Abdominal Skin in Breast Reconstruction With Deep Inferior Epigastric Artery Perforator Flap

Conditions
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Breast Reconstruction, Skin Perfusion

Intervention / Treatment
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* Device: Laser Doppler perfusion imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Secondary, unilateral breast reconstruction with a DIEAP All smokers stopped smoking 4 weeks prior to surgery Exclusion Criteria: Metastatic disease Bilateral breast reconstruction
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Laser Doppler Perfusion Imaging<br>20 consequetive cases undergoing breast reconstruction with Deep inferior epigastric artery perforator flap who had evaluation of the microcirculation of the abdominal skin with laser Doppler perfusion imaging | Device: Laser Doppler perfusion imaging<br>* LDPI is an extension of laser Doppler flowmetry (LDF) and was developed to generate a colour-coded perfusion image in a large area of skin.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perfusion of the abdominal zones measured in mean perfusion units |  | Preoperative | 
| Perfusion of the abdominal zones measured in mean perfusion units |  | two hours (After raising the flap) | 
| Perfusion of the abdominal zones measured in mean perfusion units |  | Three hours (After undermining) | 
| Perfusion of the abdominal zones measured in mean perfusion units |  | Five hours (After abdominal closure) | 
| Perfusion of the abdominal zones measured in mean perfusion units |  | Postoperative day 1 (POD1) | 
| Perfusion of the abdominal zones measured in mean perfusion units |  | Postoperative day 3 (POD3) | 
| Perfusion of the abdominal zones measured in mean perfusion units |  | Postoperative day 7 (POD7) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Breast reconstruction, Deep inferior epigastric artery perforator flap, Skin perfusion, Plastic and reconstructive surgery