Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, University Hospital A. Gemelli, Largo A. Gemelli 8, 00168, Rome, Italy.
Aesthetic Plast Surg. 2012 Apr;36(2):363-9. doi: 10.1007/s00266-011-9804-y. Epub 2011 Aug 20.
Although over the past decade the DIEP flap has emerged as one of the preferred choices for autologous breast reconstruction and the donor-site closure has much in common with the standard abdominoplasty technique, reports on comparisons of the complication rates between DIEP and elective abdominoplasty patients are not currently available. The purpose of this study was to compare DIEP donor-site and elective abdominoplasty short-term complications rates, in support of surgical choices.
Searches of MEDLINE and CENTRAL for English language articles on DIEP and elective abdominoplasty (EA) published from January 1999 through December 2009 identified 33 studies that met the inclusion criteria and included 3,937 patients. A random-effects model was used to calculate the average complication rate in the literature.
The rate of seroma/hematoma in EA (16.1%, 95% confidence interval [CI] = 12.2-20.9%) was approximately four times the rate in DIEP flap patients (3.7%, 95% CI = 1.5-8.8%) was found from analyzing the data under a random-effects model. No substantial differences in the rates of infection, abdominal/umbilical necrosis, or wound dehiscence/delayed healing between the two series of patients were detected.
This meta-analysis reveals that DIEP donor-site complication rates were comparable to those in elective abdominoplasty, and, the rate of seroma in DIEP is an even lower than that of one of the most performed procedures in plastic surgery. We argue that patients presenting for a DIEP flap should be informed about this interesting comparison.
尽管在过去的十年中，DIEP 皮瓣已成为自体乳房重建的首选方法之一，并且供区的关闭与标准的腹部整形术技术有很多共同之处，但目前尚无关于 DIEP 和择期腹部整形术患者并发症发生率的比较报告。本研究的目的是比较 DIEP 供区和择期腹部整形术（EA）的短期并发症发生率，以支持手术选择。
对 1999 年 1 月至 2009 年 12 月期间发表的关于 DIEP 和 EA 的英文文章进行了 MEDLINE 和 CENTRAL 搜索，确定了符合纳入标准并包含 3937 例患者的 33 项研究。使用随机效应模型计算文献中的平均并发症发生率。
EA 中血清肿/血肿的发生率（16.1%，95%置信区间 [CI] = 12.2-20.9%）约为 DIEP 皮瓣患者的四倍（3.7%，95% CI = 1.5-8.8%），这是在随机效应模型下分析数据得出的结果。两组患者之间的感染、腹部/脐部坏死或伤口裂开/延迟愈合的发生率无显著差异。
这项荟萃分析表明，DIEP 供区并发症发生率与择期腹部整形术相当，而 DIEP 皮瓣的血清肿发生率甚至低于整形外科中最常进行的手术之一。我们认为，为 DIEP 皮瓣就诊的患者应该了解这一有趣的比较。
