Investigating the Safety of Breast Reconstruction With the Deep Inferior Epigastric Flap in Patients With Connective Tissue Diseases.

[BACKGROUND] Connective tissue diseases (CTDs) are associated with impaired wound healing and hypercoagulability. There is currently a paucity of research examining postoperative outcomes in these patients following microsurgical procedures. We aimed to analyze postoperative outcomes in patients with CTDs following breast reconstruction with the deep inferior epigastric perforator (DIEP) flap.

[METHODS] A single-institution retrospective study was conducted consisting of all patients that underwent breast reconstruction with DIEP flaps between 2015 and 2023. Outcomes were assessed in the 90-day postoperative period, and Fisher's exact test was used to compare results between patients diagnosed with a CTD and patients who do not have CTDs.

[RESULTS] Five hundred ten DIEP flaps were performed on 286 patients. Eight of these patients, who underwent 13 DIEP flaps, were diagnosed with CTDs. The patients with and without CTDs were similar with respect to patient demographics. Patients with CTDs were not at increased risk of experiencing any major complication. However, patients with CTDs were at increased risk of experiencing fat necrosis, particularly of the breast (p < 0.05).

[CONCLUSION] Our data suggests that breast reconstruction using DIEP flaps is a safe procedure for patients who have CTDs; however, they may be at increased risk for fat necrosis of the breast, which does not require significant intervention.