TY - JOUR

T1 - A Novel Method to Estimate the Weight of the DIEP Flap in Breast Reconstruction

T2 - DIEP-W, a Simple Calculation Formula Using Paraumbilical Flap Thickness

AU - Woo, Kyong Je

AU - Kim, Eun Ji

AU - Lee, Kyeong Tae

AU - Mun, Goo Hyun

N1 - Publisher Copyright:
© 2016 by Thieme Medical Publishers, Inc.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background Preoperative estimation of abdominal flap volume is valuable for breast reconstruction, especially in lean patients. The purpose of this study was to develop a formula to estimate the weight of the deep inferior epigastric artery perforator (DIEP) flap using unidimensional parameters. Methods We retrospectively collected data on 100 consecutive patients who underwent breast reconstruction using the DIEP flap. Multiple linear regression analysis was used to develop a formula to estimate the weight of the flap. Predictor variables included body mass index, height of the flap, width of the flap, and flap thickness on computed tomography angiographic images at three paraumbilical sites: 5 cm right, left, and inferior from the umbilicus. Then we prospectively tested the accuracy of the developed formula in 38 consecutive patients who underwent breast reconstruction with free DIEP flaps. Results A calculation formula and a smartphone application, DIEP-W was developed from retrospective analysis (R 2 = 92.7%, p < 0.001). In the prospective study, the average estimated weight was 96.3% of the actual weight, giving the formula a mean absolute percentage error of 7.7% (average differences of 45 g). The flap size in the prospective group was significantly smaller (p < 0.001) and donor-site complications were less (p = 0.002) than those of retrospective group. Conclusion Surgeons can easily calculate the DIEP weight with varying flap dimensions in a real-time fashion using this formula during preoperative planning and intraoperative design. Estimating the flap weight facilitates economical use of the flap, which can lead to reduced donor-site complications.

AB - Background Preoperative estimation of abdominal flap volume is valuable for breast reconstruction, especially in lean patients. The purpose of this study was to develop a formula to estimate the weight of the deep inferior epigastric artery perforator (DIEP) flap using unidimensional parameters. Methods We retrospectively collected data on 100 consecutive patients who underwent breast reconstruction using the DIEP flap. Multiple linear regression analysis was used to develop a formula to estimate the weight of the flap. Predictor variables included body mass index, height of the flap, width of the flap, and flap thickness on computed tomography angiographic images at three paraumbilical sites: 5 cm right, left, and inferior from the umbilicus. Then we prospectively tested the accuracy of the developed formula in 38 consecutive patients who underwent breast reconstruction with free DIEP flaps. Results A calculation formula and a smartphone application, DIEP-W was developed from retrospective analysis (R 2 = 92.7%, p < 0.001). In the prospective study, the average estimated weight was 96.3% of the actual weight, giving the formula a mean absolute percentage error of 7.7% (average differences of 45 g). The flap size in the prospective group was significantly smaller (p < 0.001) and donor-site complications were less (p = 0.002) than those of retrospective group. Conclusion Surgeons can easily calculate the DIEP weight with varying flap dimensions in a real-time fashion using this formula during preoperative planning and intraoperative design. Estimating the flap weight facilitates economical use of the flap, which can lead to reduced donor-site complications.

KW - breast reconstruction

KW - DIEP flap

KW - preoperative volume estimation

UR - http://www.scopus.com/inward/record.url?scp=84964009923&partnerID=8YFLogxK

U2 - 10.1055/s-0036-1581078

DO - 10.1055/s-0036-1581078

M3 - Article

C2 - 27050336

AN - SCOPUS:84964009923

SN - 0743-684X

VL - 32

SP - 520

EP - 527

JO - Journal of Reconstructive Microsurgery

JF - Journal of Reconstructive Microsurgery

IS - 7

ER -