Defining the Standard for DIEP Donor Site Outcomes: A Decade Long Study on Microvascular Breast Reconstruction and BREAST-Q Patient Satisfaction

Abstract

Introduction: Previous studies have reported on abdominal donor site complications after DIEP breast reconstruction with a lack of standardization. The aim of this study is to be able to standardize reporting of abdominal donor site complications as well as include patient-reported outcomes based on these standards. Materials and Methods: This retrospective study was conducted on patients who underwent any type of DIEP flap breast reconstruction performed at an academic institution between January 2011 – December 2021. Patients were excluded if they had a history of breast reconstruction or abdominal surgeries, post-reconstruction radiation, or if underwent a concomitant autologous flap reconstruction. Primary outcomes of this study included abdominal donor site complications, treatment outcomes, and BREAST-Q survey responses. Results: 502 patients were evaluated in this study. Our complication rate was 35.3% of the study population, with minor complications making up 68.1% (n = 205) and major making up 31.9% (n = 96) of complications. A moderately strong association was noted between history of DVT/PE and major complications, φ = 0.174, p < 0.001. An association that was reaching significance was noted between umbilical preservation and minor complications, φ = 0.086, p = 0.055. In our logistic regression BMI, hypertension, and umbilical preservation were associated for increased association of minor complications, while BMI, race, hypertension, and history of DVT/PE were associated for increased risk of major complications. Patient cohort reported higher postoperative psychosocial well-being in minor complications (80.49, EMM) while higher postoperative physical well-being: abdomen in no complications (73.50, EMM). Conclusion: This is the first study of its kind discussing the topic of standardizing abdominal donor site complications after DIEP breast reconstruction. This form of classification can be used to dictate treatment options of patients as well as improve on factors that can reduce post-operative complications.