Development of a Mouse Model of Abdominal Cutaneous Flaps for Breast Reconstruction

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2013 Jan 12

PMID 23308122

Citations 1

Authors

Daniel John Womac

Arun Prathap Palanisamy

Rene Eslick

Dennis Kenneth Schimpf

Kenneth David Chavin

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Autologous tissue transfer, in addition to replacing tissue that was lost during injury or surgery, offers women an excellent option to improve cosmetic appearance and self-confidence following mastectomy due to breast cancer. However, flap necrosis is a complication in obese patients undergoing this procedure. We created a mouse model to study the flap-related complications that leads to decreased flap survival in autologous breast reconstruction.

Methods: Left superficial inferior epigastric (SIE) pedicle abdominal-cutaneous flaps were elevated in 8 week-old, obese ob/ob male mice and their lean littermates. Flaps were followed by serial photography. Area of flap necrosis was measured at 7 days. Statistical analysis was performed.

Results: Necrosis was observed at the distal margin of the flaps, in both lean and obese groups. Lean left SIE flaps (n = 8) had a total area flap necrosis of 9.1% at 7 days whereas obese left SIE flaps (n = 8) had a total area flap necrosis of 45.5% at 7 days. Obese flaps had a statistically significant increase in necrosis compared to the lean flaps, p = 0.001.

Conclusions: There was a significant difference between flap survival in lean and obese SIE pedicle flaps in our mouse model. We have developed the first flap model of obesity utilizing the superficial epigastric pedicle in the mouse. This model is optimal for future studies to dissect out mechanisms that lead to the complications related to flap survival for breast reconstruction, especially in obese subjects.

Citing Articles

Antitumor Immunity from Abdominal Flap-Embedded Therapeutic Cancer Vaccine.

Liu X, Mai J, Meng C, Spiegel A, Wei W, Shen H Int J Nanomedicine. 2022; 17:203-212.

PMID: 35046655 PMC: 8760982. DOI: 10.2147/IJN.S341394.

References

Cui Y, Whiteman M, Flaws J, Langenberg P, Tkaczuk K, Bush T . Body mass and stage of breast cancer at diagnosis. Int J Cancer. 2002; 98(2):279-83. DOI: 10.1002/ijc.10209. View

Kroll S, Gherardini G, Martin J, Reece G, Miller M, EVANS G . Fat necrosis in free and pedicled TRAM flaps. Plast Reconstr Surg. 1998; 102(5):1502-7. DOI: 10.1097/00006534-199810000-00024. View

Spear S, Ducic I, Cuoco F, Taylor N . Effect of obesity on flap and donor-site complications in pedicled TRAM flap breast reconstruction. Plast Reconstr Surg. 2007; 119(3):788-95. DOI: 10.1097/01.prs.0000252003.14537.d2. View

Kroll S, Netscher D . Complications of TRAM flap breast reconstruction in obese patients. Plast Reconstr Surg. 1989; 84(6):886-92. DOI: 10.1097/00006534-198912000-00003. View

Moran S, Serletti J . Outcome comparison between free and pedicled TRAM flap breast reconstruction in the obese patient. Plast Reconstr Surg. 2001; 108(7):1954-60; discussion 1961-2. DOI: 10.1097/00006534-200112000-00017. View

Dunn R, Mancoll J . Flap models in the rat: a review and reappraisal. Plast Reconstr Surg. 1992; 90(2):319-28. View

Friedman J, Halaas J . Leptin and the regulation of body weight in mammals. Nature. 1998; 395(6704):763-70. DOI: 10.1038/27376. View

Padubidri A, Browne Jr E . Modification in flap design of the epigastric artery flap in rats--a new experimental flap model. Ann Plast Surg. 1997; 39(5):500-4. DOI: 10.1097/00000637-199711000-00010. View

Tatlidede S, McCormack M, Eberlin K, Nguyen J, Randolph M, Austen Jr W . A novel murine island skin flap for ischemic preconditioning. J Surg Res. 2008; 154(1):112-7. DOI: 10.1016/j.jss.2008.05.029. View

10.

STOLL B . Teenage obesity in relation to breast cancer risk. Int J Obes Relat Metab Disord. 1998; 22(11):1035-40. DOI: 10.1038/sj.ijo.0800769. View

11.

Lindstrom P . The physiology of obese-hyperglycemic mice [ob/ob mice]. ScientificWorldJournal. 2007; 7:666-85. PMC: 5901356. DOI: 10.1100/tsw.2007.117. View

12.

Wingo P, Guest J, McGinnis L, Miller D, Rodriguez C, Cardinez C . Patterns of inpatient surgeries for the top four cancers in the United States, National Hospital Discharge Survey, 1988-95. Cancer Causes Control. 2000; 11(6):497-512. DOI: 10.1023/a:1008944209648. View

13.

INGALLS A, DICKIE M, Snell G . Obese, a new mutation in the house mouse. Obes Res. 1996; 4(1):101. DOI: 10.1002/j.1550-8528.1996.tb00519.x. View

14.

Finseth F, Cutting C . An experimental neurovascular island skin flap for the study of the delay phenomenon. Plast Reconstr Surg. 1978; 61(3):412-20. DOI: 10.1097/00006534-197803000-00016. View

15.

Enger S, Greif J, Polikoff J, Press M . Body weight correlates with mortality in early-stage breast cancer. Arch Surg. 2004; 139(9):954-58. DOI: 10.1001/archsurg.139.9.954. View

16.

Losken A, Swartz M, Van den Abbeele A, Jain R, Slavin S . A potential murine model for flap-related investigations. Plast Reconstr Surg. 2001; 107(6):1504-8. DOI: 10.1097/00006534-200105000-00032. View

17.

Chang D, Wang B, ROBB G, Reece G, Miller M, EVANS G . Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction. Plast Reconstr Surg. 2000; 105(5):1640-8. DOI: 10.1097/00006534-200004050-00007. View

18.

Ozcan G, Shenaq S, Spira M . A new flap model in the rat. Ann Plast Surg. 1991; 27(4):332-8. DOI: 10.1097/00000637-199110000-00008. View

19.

Harder Y, Amon M, Erni D, Menger M . Evolution of ischemic tissue injury in a random pattern flap: a new mouse model using intravital microscopy. J Surg Res. 2004; 121(2):197-205. DOI: 10.1016/j.jss.2004.03.026. View

20.

Selber J, Kurichi J, Vega S, Sonnad S, Serletti J . Risk factors and complications in free TRAM flap breast reconstruction. Ann Plast Surg. 2006; 56(5):492-7. DOI: 10.1097/01.sap.0000210180.72721.4a. View