Yesantharao Pooja S, Carrion Kassandra, Nguyen Dung H
Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94304, USA.
J Clin Med. 2025 Mar 3;14(5):1706. doi: 10.3390/jcm14051706.
: The omental fat-augmented free flap (O-FAFF) is a novel technique for autologous breast reconstruction in patients who cannot use or who elect not to use more traditional donor sites. While the clinical outcomes of O-FAFF have been well studied, associated costs and resource utilization have not yet been investigated. The O-FAFF technique involves the use of an acellular dermal matrix and a two-team approach for laparoscopic harvest of the omentum, thereby increasing surgical and materials costs. This study compares the longitudinal cost-effectiveness study of O-FAFF breast reconstruction compared to reconstruction using implants or abdominal donor sites (deep inferior epigastric artery flap or transverse rectus abdominis myocutaneous flap). : This cost-effectiveness analysis compared O-FAFF to abdominal free flap and implant-based reconstruction in adults. Markov cohort modeling was used to study cost-effectiveness from the payer perspective. : Compared to implant-based reconstruction, the incremental cost of O-FAFF reconstruction was USD 9227 and the incremental gain in breast quality-adjusted life-year (B-QALY) was 0.95, resulting in an incremental cost-effectiveness ratio of USD 9712.64/B-QALY gained, which is well under the acceptable cost-effectiveness threshold of USD 50,000 per B-QALY. Compared to abdominal flap reconstruction, O-FAFF reconstruction was associated with an incremental decrease in direct costs of USD 1410.10 and an incremental gain in B-QALYs of 0.36 and was thus the dominant strategy. : The O-FAFF breast reconstruction technique is a cost-effective alternative to more traditional methods of breast reconstruction, including abdominal free flap techniques and implant-based reconstruction. As such, the O-FAFF technique represents an important novel modality for primary autologous reconstruction.
网膜脂肪增加游离皮瓣（O-FAFF）是一种用于无法使用或选择不使用更传统供区的患者进行自体乳房重建的新技术。虽然O-FAFF的临床结果已得到充分研究，但相关成本和资源利用情况尚未得到调查。O-FAFF技术涉及使用脱细胞真皮基质和采用双团队方法通过腹腔镜获取网膜，从而增加了手术和材料成本。本研究比较了O-FAFF乳房重建与使用植入物或腹部供区（腹壁下深动脉皮瓣或腹直肌肌皮瓣）重建的纵向成本效益。：这项成本效益分析比较了成人中O-FAFF与腹部游离皮瓣和基于植入物的重建。采用马尔可夫队列模型从支付方角度研究成本效益。：与基于植入物的重建相比，O-FAFF重建的增量成本为9227美元，乳房质量调整生命年（B-QALY）的增量增益为0.95，导致增量成本效益比为每获得一个B-QALY 9712.64美元，远低于每B-QALY 50000美元的可接受成本效益阈值。与腹部皮瓣重建相比，O-FAFF重建的直接成本增量减少1410.10美元，B-QALY增量增益为0.36，因此是主导策略。：O-FAFF乳房重建技术是一种比包括腹部游离皮瓣技术和基于植入物的重建等更传统乳房重建方法更具成本效益的替代方案。因此，O-FAFF技术代表了一种重要的新型一期自体重建方式。
