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CC BY-NC-ND 4.0 · Indian J Plast Surg
DOI: 10.1055/s-0044-1781445
Original Article

Outcomes of Deep Inferior Epigastric Artery Perforator (DIEP) Flap in Indian Population—A Prospective Single-Institute Study

Annika Marwah
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, Karnataka, India
,
Ashok Basur Chandrappa 
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, Karnataka, India
,
Srikanth Vasudevan
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, Karnataka, India
,
Ananteshwar Y.N. Yelambalase Rao
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, Karnataka, India
,
Dinkar Sreekumar
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, Karnataka, India
,
Pooja Shetty
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, Karnataka, India
,
Serena Bharathkar
1   Department of Plastic and Reconstructive Surgery, Manipal Hospital, Bangalore, Karnataka, India
,
Somashekhar SP
2   Aster International Institute of Oncology, Consultant Surgical Oncology Aster CMI Hebbal/ Aster Whitefield Hospital, Bangalore, Karnataka, India
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Abstract

Introduction Breast reconstruction has become integral part of breast cancer treatment. Deep inferior epigastric perforator (DIEP)-based flap is considered the gold standard in autologous breast reconstruction.

Aims and Objectives The aim of this study was to evaluate the patient satisfaction and the incidence of complications in DIEP flaps in an Indian setup for breast reconstruction.

Materials and Methods This is a prospective, nonrandomized study at a single institute—Manipal Hospitals, Old Airport Road, Bangalore. Eligible patients were women aged between 28 and 60 years with primary breast cancer requiring mastectomy and radiotherapy, who consented for DIEP flap reconstruction.

Results The study includes subjects who had autologous breast reconstruction after mastectomy with DIEP flap between January 2019 and August 2021 that included 31 patients with a minimum follow-up of 2 years. Four flaps were turbocharged and 17 flaps were superdrained primarily. The average operative time for the whole procedure by adopting a two-team approach is 353.8 ± 43.793 minutes. About 94.1% patients had excellent aesthetic score results. Six patients developed mastectomy flap necrosis, one had fat necrosis that was managed conservatively, whereas one patient had donor site re-exploration for hematoma. We had no DIEP flap necrosis, seroma, flap site hematoma, or flap failure. Physical well-being module of Breast-Q indicated an average of 83 points, psychosocial well-being module indicated 80 points, whereas sexual scores reverted an average of 77 points. Among satisfaction module, aesthetic outcomes for breast showed an average of 94 points, whereas the donor site had 96 points. Satisfaction with information, surgeon, medical staff each gained more than 87 points.

Conclusion Breast reconstruction with DIEP flap yields good aesthetic outcomes and quality of life in Indian population. The incidence of fat necrosis, flap and donor site complications is less over time and will enhance the patient satisfaction score further.

Keywords

deep inferior epigastric perforator flap - autologous breast reconstruction - Breast-Q - patient satisfaction

Authors' Contributions

A.B.C, S.V., and A.Y.N. conceptualized the study. A.M. collected the data, curated the graphics, did the statistics, and wrote the article. D.S., P.S., and S.B. helped with data collection. S.S.P. was involved surgically with mastectomy. All eight authors have read and approved the final manuscript and declare no conflicts of interest.




Publication History

Article published online:
18 March 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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