by Jessica, Anne Savage; Zhao, Jade; Mackey, Simon;
Blackburn, Adam Victor
Plastic and Reconstructive Surgery: August 2022 -
Volume 150 - Issue 2 - p 258-268
Background:
The transverse upper gracilis flap is an important
reconstructive option for patients who desire autologous reconstruction after
mastectomy but in whom a deep inferior epigastric perforator flap is
unavailable or undesirable. The authors present an analysis of outcomes and
patient satisfaction results, from a consecutive series in a single
institution.
Methods:
Using a prospectively populated free flap database, all
patients undergoing transverse upper gracilis flap breast reconstruction for a
mastectomy defect between January of 2013 and December of 2017 were identified.
Retrospective review of clinical notes, admissions, and discharge information
was conducted to identify outcomes, secondary operations, and complications.
All patients were contacted by letter and invited to take part in a patient
satisfaction survey a minimum of 12 months after free-flap surgery.
Results:
Seventy-eight patients underwent transverse upper gracilis
flap breast reconstruction using a total of 103 transverse upper gracilis flaps
to reconstruct 99 breast mounds in the 5-year period studied. Patient
satisfaction is evidenced by BREAST-Q scores showing 81 ± 19 percent
Satisfaction with Breasts, 80 ± 20 percent Psychosocial Well-Being, and 84 ± 19
percent Physical Well-Being of the chest. Forty-six of 53 (87 percent) report
satisfaction with the postoperative appearance of their thigh unclothed and 51
of 53 (96 percent) report satisfaction clothed.
Conclusions:
This is the first consecutive series of transverse upper
gracilis flap breast reconstruction outcomes that presents BREAST-Q scores for
multiple, postoperative reconstruction modules and details complications
stratified by Clavien-Dindo score. The methodology can be easily replicated and
benchmarked against. Our donor-site complication rates are lower than previous
publications and patient satisfaction data reveal that this is a well-accepted
option for patients.
