Comparing sensation of common donor site regions for autologous breast reconstruction to a healthy breast.

Publication date: Available online 25 September 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Anouk J.M. Cornelissen, Jop Beugels, Arno Lataster, Esther M. Heuts, Shai M. Rozen, Aldona J. Spiegel, René R.W.J. van der Hulst, Stefania M.H. Tuinder
IntroductionAutologous breast reconstruction has become standard care for breast cancer patients. Although excellent cosmetic results can be achieved, most reconstructed breasts fail to regain normal sensation. Nerve coaptation of the flap has been suggested to improve sensation, the effect of the donor flap native sensory threshold, on the degree of sensory restoration has yet to be determined. The aim of this study is to evaluate the differences in sensation between various potential donor site regions in comparison to sensation of the healthy breast.Patients and methodsIn the Maastricht University Medical Centre a cross-sectional study in healthy women was performed. Monofilaments were used to measure sensation in the breast and at different flap donor sites: Deep Inferior Epigastric Perforator (DIEP), Lateral Thigh Perforator (LTP), Profunda Artery Perforator (PAP), Superior Gluteal Artery Perforator (SGAP) and Transverse Musculocutaneous Gracilis (TMG) flap. The Wilcoxon Signed Rank Test was used to analyse statistical significance in sensation.ResultsFifty women with a mean age of 49±2.72 years and mean BMI of 26.14±0.89 kg/m² were included in the study. The median monofilament value of the normal breasts was 2.97(2.56-3.55). The median monofilament value of each donor site and p value when compared to the healthy breast were: DIEP-flap 2.62(2.36-3.22) p <0.01, LTP-flap 3.61(2.83-4.08) p<0.01, PAP-flap 3.09(2.67-3.5) p=0.97, SGAP-flap 3.22(2.64-3.87) p=0.01 and TMG-flap 3.03(2.6-3.47) p=0.69.ConclusionsThere is a significant difference in sensation between the various donor site regions for breast reconstruction and the healthy breast. This might be taken into consideration for donor site selection.



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