Hyperbaric oxygen therapy outcomes in post-irradiated patient undergoing microvascular breast reconstruction: A preliminary retrospective comparative study
Matteo Scampa,
Jérôme Martineau,
Sylvain Boet,
Rodrigue Pignel,
Daniel F. Kalbermatten,
Carlo M. Oranges
Affiliations
Matteo Scampa
Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, Switzerland
Jérôme Martineau
Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, Switzerland
Sylvain Boet
Subaquatic and Hyperbaric Medicine Unit, Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1205, Geneva, Switzerland; Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, K1H 8L6, Canada; Institut du Savoir Montfort, Ottawa, ON, K1K 0T2, Canada
Rodrigue Pignel
Subaquatic and Hyperbaric Medicine Unit, Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1205, Geneva, Switzerland
Daniel F. Kalbermatten
Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, Switzerland
Carlo M. Oranges
Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, Switzerland; Corresponding author: Carlo M. Oranges, MD, PhD, PD, Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland Phone: +41 (0)22 372 79 97
Summary: Introduction: Radiotherapy is a challenge in autologous breast reconstruction because of its impact on cutaneous and vascular systems. Hyperbaric oxygen therapy (HBOT) is a recognized treatment of radiation-related complications. We aimed to assess the impact of perioperative HBOT on irradiated breast microvascular reconstructive outcomes. Method: We reviewed the medical charts of patients who received radiotherapy and then underwent secondary free autologous breast reconstruction at our institution. Data on demographics, HBOT protocol, intervention characteristics and post-operative complications were collected. Outcomes of the irradiated patients were then compared between the HBOT and non-HBOT groups. Results: Fourteen patients were included (11 unilateral and 2 bilateral deep inferior epigastric artery perforator flaps and 1 free transverse rectus abdominis muscle flap). Seven patients received HBOT and 7 did not. In the non-HBOT group, there were 1 Clavien–Dindo grade II, 1 Clavien–Dindo grade IIIa and 2 Clavien–Dindo grade IIIb post-operative complications. In the HBOT group, there were 3 Clavien–Dindo grade I, 1 Clavien–Dindo grade IIIa and 2 Clavien–Dindo grade IIIb post-operative complications. The mean operative time was 452.3 minutes (SD ±62.4 minutes) for unilateral cases without HBOT and 457.8 minutes (SD ±102.1 minutes) with HBOT (p=0.913). Mean ischaemia time per flap without HBOT was 109.4 minutes (SD ±51.8 minutes) versus 80.1 minutes (SD ±37.7 minutes) in the HBOT group (p=0.249). Conclusion: This study provides insights into the potential of HBOT treatment in preparing patients with irradiated breast cancer for secondary autologous reconstruction.
