PRS AAPS Oral Proofs 2016
Jonas A. Nelson, MD,* Michael G. Tecce, BS,* Michael A. Lanni, BS,* Jesse C. Selber, MD,† Lisa C. Wu, MD,* Joseph M. Serletti, MD*
From the *University of Pennsylvania, Philadelphia, Pa.; and †The University of Texas, Houston, Tex.
PURPOSE: The purpose of this study is to provide long-term, subjective, and objective functional data on patients undergoing autologous breast reconstruction using abdominal tissue and to assess factors impacting functional differences.
METHODS: Patients participated in this prospective study between 2005 and 2015, completing preoperative, early, and late subjective and objective evaluations. Objective examination included an assessment of upper abdominal and lower abdominal strength and functional independence. Patient-reported outcomes included the Short-Form 36 (SF36) and the Breast Q. Scores were compared by laterality and flap type, and a logistic regression was performed to determine the factors influencing function.
RESULTS: Fifty-one patients completed long-term follow-up, averaging 6.9 years (range, 5–10 years). Overall, 78.8% of patients had stable or improved scores across the upper abdominal and lower abdominal strength and functional independence, with no significant differences based on laterality or flap types. Subjectively, 90% demonstrated improvement in SF36 physical health component. Obesity and comorbid conditions were risk factors for scoring in the lowest third of SF36 physical health component scores (P = 0.012). Further, obesity was determined to negatively impact both the mental (P < 0.005) and the physical (P < 0.001) components as well as change in mental health score (P < 0.026).
CONCLUSIONS: Abdominally based autologous breast reconstruction does not appear to cause long-term strength or functional impairment. However, obese patients may be at risk for long-term subjective physical and mental health impairment.