Nerve Coaptation in LTP Flap Breast Reconstruction

Study Overview
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Brief Summary
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The sensory recovery of the breast remains an undervalued aspect of breast reconstruction and surgical reinnervation is not regarded as a priority by most reconstructive surgeons. A prospective study was conducted of all patients who underwent either innervated or non-innervated lateral thigh perforator (LTP) flap breast reconstruction in Maastricht University Medical Center and returned for follow-up between February 2016 and April 2019. Semmes-Weinstein monofilaments were used for sensory testing of the breast.

Official Title
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Sensory Recovery of the Breast Following Innervated and Non-innervated Lateral Thigh Perforator (LTP) Flap Breast Reconstructions

Conditions
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Breast Cancer

Intervention / Treatment
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* Procedure: Sensory nerve coaptation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female patients 18 years or older Unilateral or bilateral LTP flap breast reconstruction Returned for follow-up between February 2016 and April 2019 Informed consent Exclusion Criteria: In case of a total flap loss Flaps that required a take-back Follow-up less than six months postoperatively

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Innervated LTP flaps<br>Patients in this group underwent immediate or delayed, unilateral or bilateral lateral thigh perforator (LTP) flap breast reconstruction with additional sensory nerve coaptation. | Procedure: Sensory nerve coaptation<br>* A recipient sensory nerve branch of the lateral cutaneous femoral nerve (LCFN) was reattached to a donor nerve in the chest area. The anterior cutaneous branch of the second or third intercostal nerve was used as the donor nerve. Direct, end-to-end nerve coaptation was performed.<br>* Other names: Reinnervation;|
| Non-innervated LTP flaps<br>Patients in this group underwent immediate or delayed, unilateral or bilateral lateral thigh perforator (LTP) flap breast reconstruction without sensory nerve coaptation. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The sensory recovery of the reconstructed breast as assessed by Semmes-Weinstein monofilaments | The sensory recovery of the breast to touch was tested at different follow-up moments after the initial surgery. Semmes-Weinstein monofilaments were used for sensory testing. Nine areas of the breast, indicating native skin and flap skin, were tested. Mean monofilament values were calculated for each area and compared between groups. | Through study completion up to 27 months postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Breast reconstruction, LTP flap, Sensory recovery, Breast sensation, Nerve coaptation