Risk factors and predictive models for fat necrosis in DIEP flap breast reconstruction: A systematic review.
Lateral row perforators cut fat necrosis rates versus medial row in deep inferior epigastric perforator flaps
Risk factors and predictive models for fat necrosis in DIEP flap breast reconstruction: A systematic review.
Autologous breast reconstruction is an integral component of post-mastectomy care.
This systematic review evaluates risk factors associated with fat necrosis following deep inferior epigastric perforator flap breast reconstruction to inform clinical decision-making and optimize outcomes.
A systematic search of PubMed, MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library was conducted in accordance with PRISMA guidelines.
lateral row perforators cut fat necrosis risk versus medial row
Fat necrosis incidence ranged from 7.5% to 59.5%.
Deep inferior epigastric perforator flaps were associated with higher rates of vascular compromise requiring reoperation (13% p = 0.003).
Intraoperative indocyanine green angiography was associated with reduced fat necrosis (RR 0.49; 95% CI, 0.25-0.97; p = 0.021).
Higher flap weight and body mass index greater than 30 kg/m² were consistent predictors.
Fat necrosis remains a predominant complication following deep inferior epigastric perforator flap breast reconstruction.
Optimization of patient selection, perforator strategy, and intraoperative perfusion assessment may reduce ischemic morbidity and improve reconstructive outcomes.