Breast Reconstruction in Elderly (>60 years) Women using Deep Inferior Epigastric Perforator Flaps (DIEP) is Safe and Viable: a Comparative Study Syventävien opintojen kirjallinen työ Jarna Heikkinen Kevätlukukausi

Abstract

There is still debate concerning the indications for microsurgical breast reconstruction, particularly deep inferior epigastric perforator (DIEP) flap in elderly women concerning its safety. Free tissue transfer still carries the risk of perioperative morbidity and mortality in elderly patients. To clarify this issue, a comparative study was performed. This is a retrospective cohort study including all unilateral DIEP breast reconstructions performed in a single institution. Patients were divided into two groups based on age: an elderly cohort (>60 years) and a non-elderly cohort (<60 years). Primary outcomes were complete and partial flap as well as the need for flap re-exploration. Demographic and comorbidity data were analyzed as secondary predictor variables. Secondary outcomes included surgical site occurrences, such as seroma, as well as medical complications. A total of 214 flaps were included in this study, 177 in the non-elderly cohort and 37 flaps in the elderly one. There were no significant differences in the incidence of total or partial flap loss between the two cohorts, or flap re-exploration. Similarly, there were no differences in postoperative complications between the groups). The success rate of the non-elderly cohort was 94.6 and the success rate of the elderly cohort was 96.6 percent. Microsurgical breast reconstruction using DIEP is safe in elderly patients, and should not be denied DIEP flaps because of their age alone.