Free flap breast reconstruction is a viable and safe procedure in elderly patients, according to a study published in the December issue of Plastic and Reconstructive Surgery.
Radbeh Torabi, M.D., from the Louisiana State University Health Sciences Center in New Orleans, and colleagues conducted a chart review of all deep inferior epigastric perforator flap breast reconstruction patients at a single institution. Patients were divided into an elderly cohort (≥65 years; 54 flaps) and a nonelderly cohort (<65 years; 285 flaps).
The researchers found that the elderly cohort had higher rates of diabetes, hypertension, and hyperlipidemia; however, there were no significant differences in primary outcomes (complete flap loss, partial flap loss, or need for flap reexploration) between the two cohorts. The elderly cohort did have significantly higher breast wound dehiscence. Being elderly was seen as a significant risk factor for complete flap loss (odds ratio, 10.92). The overall success rate was 99.6 percent for the nonelderly cohort and 96.3 percent for the elderly cohort.
"We as plastic surgeons must be prepared to consult elderly patients before their mastectomies, so that we can plan reconstructions in a fashion similar to that for younger patients," the authors write.