Evaluation of Pedicled Omental Flap Delivered through a Minilaparotomy for Immediate Breast Reconstruction in Obese Patients

Abstract

Studies have shown the laparoscopically harvested omental flap to be a successful method for immediate breast reconstruction. However, data about its usefulness and safety in obese women are limited. This study examined the effectiveness and safety of a pedicled omental flap delivered via a minilaparotomy in women with a body mass index (BMI) higher than 30 kg/m(2). Women candidates for skin-sparing mastectomy underwent reconstruction with delivery of a pedicled omental flap via a minilaparotomy. Surgery was performed for 24 women with a mean age of 57.54 years and a mean BMI of 32.54 kg/m(2). The operative time was prolonged by about 1 h without excess blood loss or prolongation of their hospital stay. Except for a single case of partial flap necrosis, no single total flap loss was recorded. In three patients (12.5 %), the flap volume was inadequate, and silicone implant was used as an adjunct. Only one patient (4 %) experienced a small incisional hernia. The majority of the patients (67 %) described their cosmetic outcome as excellent. Delivery of a pedicled omental flap via a minilaparotomy is a safe and reliable method for immediate breast reconstruction after skin-sparing mastectomy in women with a BMI higher than 30 kg/m(2). This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .