Presentamos nuestra experiencia en 9 pacientes mastectomizadas, seis de ellas radiadas, reconstruidas en fase crónica con colgajos microquirúrgicos de perforante (ocho de la arteria epigástrica inferior y uno de la arteria glútea superior). El seguimiento mínimo tras la reconstrucción ha sido de 12 meses.
Todos los casos sobrevivieron. En uno se produjo una complicación intraoperatoria: la avulsión del pedículo, que se pudo solucionar sin consecuencias. En dos casos hemos observado pequeñas áreas de necrosis grasa que evolucionaron favorablemente con tratamiento conservador. La valoración de los resultados estéticos por parte de las pacientes ha sido muy satisfactoria.
En nuestra opinión, los colgajos de perforante constituyen una excelente opción reconstructora, incluso en pacientes sometidas a radioterapia. Su vascularización y vitalidad permiten reconstruir una mama con un magnífico resultado estético y una mínima morbilidad. No obstante, hay que considerar la complejidad técnica y el mayor riesgo de complicaciones vasculares en casos de radioterapia previa.
We present our experience in nine patients who underwent mastectomy (six also underwent radiation therapy) in whom breast reconstruction was performed in the chronic phase with microsurgical perforator flaps (eight of the inferior epigastric artery and one of the superior gluteal artery). The minimum follow- up after reconstruction was twelve months.
All the flaps remained viable. There was one intraoperative complication, consisting of avulsion of the pedicle, which was resolved without sequela. In two patients, small areas of fat necrosis were observed, which were resolved with conservative treatment. The patients were highly satisfied with the cosmetic results.
In our experience, perforator flaps constitute an excellent option in breast reconstruction, even in patients undergoing radiotherapy. Their vascularization and strength leads to excellent cosmetic results and minimal morbidity. Nevertheless, the technique is complicated and the risk of vascular complications is increased in patients with prior radiotherapy.
