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Neurotization Does not Prolong Operative Time in Free Flap Breast Reconstruction

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  • Breast Surgery
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Abstract

Background

Neurotization during the breast reconstruction process can improve patient quality-of-life and satisfaction with reconstructive outcomes. One concern with neurotization is increased total operative time due to the need for additional dissection and nerve coaptation. The purpose of this study was to compare total operative time between neurotized and non-neurotized abdominal-based, free flap breast reconstruction.

Methods

A retrospective review was conducted of consecutive patients who underwent unilateral, abdominal-based, free flap breast reconstruction between 2016 and 2018 at a single tertiary care center. Data were collected on patient demographics, surgical techniques, and length of surgery. Data analysis was performed using chi-square test, independent t-test, and multivariate linear regression analysis. A p-value ≤0.05 was considered statistically significant.

Results

Seventy-three patients were included in this study. Twenty-three patients (31.50%) underwent flap neurotization (N group) and 50 (68.49%) underwent standard breast reconstruction without neurotization (NO group). The groups were similar in age, BMI, smoking status, and ASA class. No difference was found between the two groups in timing of reconstruction (p = 0.388). Average operative times were 467.73 ± 145.52 minutes and 455.28 ± 111.19 minutes for the N and NO groups, respectively, with no significant difference between the two groups (two-tailed p-value = 0.72).

Conclusion

Seamless integration of neurotization in abdominal-based, free flap breast reconstruction is possible without significant prolongation of total operative time.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Funding

There was no funding for this study.

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Authors and Affiliations

  1. School of Medicine, Case Western Reserve University, 9501 Euclid Avenue, Cleveland, OH, 44195, USA

    Thomas Y. Xia

  2. Division of Plastic Surgery, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC, 29425, USA

    Isis Scomacao

  3. Department of Plastic Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Risal Djohan, Raffi Gurunian & Graham S. Schwarz

  4. Department of Plastic Surgery, Allegheny Health Network, 320 E North Ave, Pittsburgh, PA, 15212, USA

    Andrea Moreira

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  1. Thomas Y. Xia
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  2. Isis Scomacao
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  3. Risal Djohan
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  6. Graham S. Schwarz
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Corresponding author

Correspondence to Graham S. Schwarz.

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Dr. Risal Djohan is a speaker for Axogen. None of the other authors have conflict of interest to declare pertaining to this study.

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Xia, T.Y., Scomacao, I., Djohan, R. et al. Neurotization Does not Prolong Operative Time in Free Flap Breast Reconstruction. Aesth Plast Surg 46, 2159–2163 (2022). https://doi.org/10.1007/s00266-022-02833-7

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  • DOI: https://doi.org/10.1007/s00266-022-02833-7

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