FVI Equation Can Assess Blood Flow to DIEP Flaps for Breast Reconstruction
For women undergoing mastectomy, breast reconstruction is an effective surgical procedure that helps to restore natural-looking breasts. After BRA day campaigns and lectures, more women are now aware of the options that could make their life better. Some prefer breast implants reconstruction whereas others go for the more natural fat transfer option when their own fat cells are used to provide breast volume. The DIEP flap is a relatively new choice for delayed reconstruction after breast cancer surgery. A new study has put forward an equation to assess DIEP flap breast reconstruction results. According to a research paper published in Plastic and Reconstructive Surgery -- Global OpenŽ, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS), a simple formula can reliably tell whether there will be sufficient blood flow to nourish the DIEP flap. In DIEP flap reconstruction, the skin and tissue from the patient’s abdomen is used to reconstruct the breasts. It leaves the patient's abdominal muscles intact. An ultrasound study was performed to see how fine the flap viability index (FVI) equation predicted blood flow in vessels used for DIEP flap breast reconstruction. In
women undergoing this procedure, the FVI can help ensure "optimal flap perfusion and complete flap survival." You can find the details of the study here. Here are some salient points related to the study.
FVI method is used to calculate the tissue weight which could be safely nourished by the available donor arteries, or "perforators."
FVI was calculated using data on the diameter of the available vessels and the weight of the final flap.
It was noted that if FVI is over ten, total flap survival is likely. At lower FVI scores, blood supply will likely be inadequate, and partial tissue death (necrosis) is possible.
10 women undergoing breast reconstruction using the DIEP flap were involved in the study.
Using color Doppler ultrasound, the researchers measured actual blood flow in the perforating arteries within 24 hours after the procedure.
The patients had an average FVI score of 14.2, which is rated as above the "safe" value.
The blood flow measurements were extremely correlated with the diameter of the perforating arteries and so was the weight of the DIEP flap, even though to a lesser extent. FVI equation takes account of both of these factors.
Researchers say that the findings substantiate that the size of the perforating vessels is "a critical factor in optimizing blood flow" to the DIEP flap. The report persuades plastic and reconstructive surgeons to include the FVI into their regular planning for DIEP reconstruction. This acts as a simple but reliable tool for improving the quantity of viable tissue available for reconstruction. This in turn increases the chances for surgical success and patient satisfaction. The researchers say that they have had no flap necrosis in any of their DIEP Flap reconstructions after they started consistently ensuring FVI values greater than 10.
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