Minimizing Donor Site Morbidity in Abdominally Based Free Flap Breast Reconstruction | Sponsored by BD Phasix™ Mesh | Insights from Industry-Minimizing Donor Site Morbidity in Abdominally Based Free Flap Breast Reconstruction (Sponsored by BD Phasix™ Mesh)

Minimizing Donor Site Morbidity in Abdominally Based Free Flap Breast Reconstruction (Sponsored by BD Phasix™ Mesh) | Insights from Industry

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Video Transcription

Video Summary

The webinar, supported by the American Society of Plastic Surgeons and Becton Dickinson’s P4HB technology, focused on minimizing donor site morbidity in abdominally based free flap breast reconstruction. Drs. Venturi and Piccolo, both expert plastic surgeons, discussed advanced microsurgical techniques emphasizing muscle-sparing approaches like the DIEP flap to maintain abdominal wall integrity and achieve aesthetically balanced breast reconstructions. Dr. Venturi highlighted the importance of detailed preoperative imaging (CTA angiograms) to identify optimal perforators and minimize muscle damage. Both surgeons advocate for meticulous fascial closure reinforced with absorbable synthetic mesh, specifically Phasix mesh (poly-4-hydroxybutyrate), which provides long-term support during muscle recovery and absorbs predictably over 12–18 months without inflammation, reducing bulge and hernia rates.<br /><br />Dr. Piccolo expanded on the benefits of a team-based surgical model, involving co-surgeons and physician assistants, which reduces operative time, costs, and complications. He reviewed literature showing mesh use decreases hernia incidence without statistically significant differences based on mesh plane placement (onlay, inlay, sublay). Both surgeons prefer mesh reinforcement—Dr. Venturi favors onlay for ease, while Dr. Piccolo favors sublay to offload fascial tension. They emphasized that perforator quality, rather than number, dictates flap success and muscle preservation. The webinar concluded with a Q&A where they addressed clinical practices and coding for abdominal wall reinforcement.

Keywords

free flap breast reconstruction

donor site morbidity

DIEP flap

muscle-sparing techniques

preoperative imaging

CTA angiograms

Phasix mesh

mesh reinforcement

team-based surgical model