Schwaiger Karl, Weitgasser Laurenz, Mahrhofer Maximilian, Bachleitner Kathrin, Abed Selim, Wimbauer Julia, Russe Elisabeth, Schoeller Thomas, Wechselberger Gottfried
Department of Plastic, Reconstructive and Aesthetic Surgery Hospital of the Brothers of St. John of God (Barmherzige Brüder), Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University Tübingen, 72074 Tübingen, Germany.
J Clin Med. 2021 Mar 1;10(5):926. doi: 10.3390/jcm10050926.
The transverse myocutaneous gracilis (TMG) flap has become a popular and reliable alternative for autologous breast reconstruction. Initially described as a valuable tissue source for women with low body-mass index, indications nowadays have widely expanded. The Western civilization demographic development with its aging population and the steady growing average BMI has led to increasing breast reconstructions with TMG flaps in overweight and aged individuals.
A total of 300 TMG free flaps for unilateral autologous breast reconstruction were evaluated in the form of a retrospective double center cohort study. Data extraction, study group formation and statistical analysis (One-way analysis of variance (ANOVA), Pearson's chi-squared statistical analysis and relative risk calculation) were done specifically to evaluate age and BMI as risk factors for postoperative complications and outcome.
No significant differences in patients' age and BMI in the complication groups compared to the no-complication group could be found. No significant difference regarding the occurrence of complications could be found in any of the formed risk-groups. No significant increase of minor-, major- or overall complications, flap loss or revision surgeries were found in the elderly patient groups or for patients with overweight.
Age and overweight do not significantly increase the risk for postoperative complications after breast reconstructions with free TMG flaps. The findings of this study support the fact that microsurgical breast reconstruction with a free TMG flap should not solely be reserved for younger patients and females with a lower BMI.
横行股薄肌肌皮瓣（TMG瓣）已成为自体乳房重建的一种常用且可靠的选择。最初它被描述为低体重指数女性的重要组织来源，如今其适应症已广泛扩大。西方文明的人口发展伴随着人口老龄化以及平均体重指数的稳步增长，导致超重和老年个体中使用TMG瓣进行乳房重建的情况日益增多。
以回顾性双中心队列研究的形式，对300例用于单侧自体乳房重建的游离TMG瓣进行了评估。专门进行了数据提取、研究组形成及统计分析（单因素方差分析（ANOVA）、Pearson卡方统计分析和相对风险计算），以评估年龄和体重指数作为术后并发症及结局的危险因素。
与无并发症组相比，并发症组患者的年龄和体重指数无显著差异。在所形成的任何风险组中，并发症的发生率均无显著差异。在老年患者组或超重患者中，未发现轻微、严重或总体并发症、皮瓣丢失或翻修手术有显著增加。
年龄和超重并不会显著增加游离TMG瓣乳房重建术后的并发症风险。本研究结果支持以下事实，即游离TMG瓣显微外科乳房重建不应仅局限于年轻患者和低体重指数女性。
