Chest wall perforator flaps for breast reconstruction: international survey on attitudes and training needs

Andreas Karakatsanis; Malin Sund; Nicola Rocco; Jill R Dietz; Ashutosh Kothari; Mustapha Hamdi; Yazan A Masannat; Peter A Barry

doi:10.1093/bjs/znad145

Chest wall perforator flaps for breast reconstruction: international survey on attitudes and training needs

Andreas Karakatsanis^* (Corresponding Author), Malin Sund, Nicola Rocco, Jill R Dietz, Ashutosh Kothari, Mustapha Hamdi, Yazan A Masannat, Peter A Barry

^*Corresponding author for this work

Applied Medicine

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

BACKGROUND: Volume replacement using chest wall perforator flaps (CWPFs) is a promising technique to reduce mastectomy rates without sacrificing function or aesthetics. Owing to limited availability of the technique, only a minority of patients currently have access to CWPF procedures.

METHODS: An international web-based survey was disseminated through social media, dedicated webpages, and national and international societies for breast surgery. The survey explored surgeons' attitudes towards CWPFs and their perceived training needs.

RESULTS: Of 619 respondents, 88.4 per cent agreed that CWPF surgery was desirable, with one-third offering it and performing a median of 10 (i.q.r. 5-15) procedures annually. They were more likely to be senior (OR 1.35, 95 per cent c.i. 1.18 to 1.55; P < 0.001), with formal oncoplastic training (OR 4.80, 3.09 to 7.48; P < 0.001), and working in larger units (OR 1.18, 1.03 to 1.35; P = 0.018) with a free-flap (OR 1.62, 1.06 to 2.48; P = 0.025) or CWPF (OR 3.02, 1.87 to 4.89; P < 0.001) service available. In cluster and latent class analysis, none showed high cohesion with performance of CWPF surgery.

CONCLUSION: There is a discrepancy between perceived importance and availability of CWPF surgery, indicating that optimal training is needed.

Original language	English
Article number	e191
Pages (from-to)	1-7
Number of pages	7
Journal	The British journal of surgery
Volume	48
Early online date	1 Jun 2023
DOIs	https://doi.org/10.1093/bjs/znad145
Publication status	E-pub ahead of print - 1 Jun 2023

Bibliographical note

Data Availability Statement

The full data set of the survey will be available upon reasonable
request to A.K. following completion of the PERDITA project and
after a data-sharing agreement has been signed.

Keywords

breast surgery
education

Access to Document

10.1093/bjs/znad145Licence: CC BY

Karakatsanis_BJS_Chest_Wall_Perforator_VOR
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited
Final published version, 257 KBLicence: CC BY

Cite this

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title = "Chest wall perforator flaps for breast reconstruction: international survey on attitudes and training needs",

abstract = "BACKGROUND: Volume replacement using chest wall perforator flaps (CWPFs) is a promising technique to reduce mastectomy rates without sacrificing function or aesthetics. Owing to limited availability of the technique, only a minority of patients currently have access to CWPF procedures.METHODS: An international web-based survey was disseminated through social media, dedicated webpages, and national and international societies for breast surgery. The survey explored surgeons' attitudes towards CWPFs and their perceived training needs.RESULTS: Of 619 respondents, 88.4 per cent agreed that CWPF surgery was desirable, with one-third offering it and performing a median of 10 (i.q.r. 5-15) procedures annually. They were more likely to be senior (OR 1.35, 95 per cent c.i. 1.18 to 1.55; P < 0.001), with formal oncoplastic training (OR 4.80, 3.09 to 7.48; P < 0.001), and working in larger units (OR 1.18, 1.03 to 1.35; P = 0.018) with a free-flap (OR 1.62, 1.06 to 2.48; P = 0.025) or CWPF (OR 3.02, 1.87 to 4.89; P < 0.001) service available. In cluster and latent class analysis, none showed high cohesion with performance of CWPF surgery.CONCLUSION: There is a discrepancy between perceived importance and availability of CWPF surgery, indicating that optimal training is needed.",

keywords = "breast surgery, education",

author = "Andreas Karakatsanis and Malin Sund and Nicola Rocco and Dietz, {Jill R} and Ashutosh Kothari and Mustapha Hamdi and Masannat, {Yazan A} and Barry, {Peter A}",

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T1 - Chest wall perforator flaps for breast reconstruction

T2 - international survey on attitudes and training needs

AU - Karakatsanis, Andreas

AU - Sund, Malin

AU - Rocco, Nicola

AU - Dietz, Jill R

AU - Kothari, Ashutosh

AU - Hamdi, Mustapha

AU - Masannat, Yazan A

AU - Barry, Peter A

PY - 2023/6/1

Y1 - 2023/6/1

N2 - BACKGROUND: Volume replacement using chest wall perforator flaps (CWPFs) is a promising technique to reduce mastectomy rates without sacrificing function or aesthetics. Owing to limited availability of the technique, only a minority of patients currently have access to CWPF procedures.METHODS: An international web-based survey was disseminated through social media, dedicated webpages, and national and international societies for breast surgery. The survey explored surgeons' attitudes towards CWPFs and their perceived training needs.RESULTS: Of 619 respondents, 88.4 per cent agreed that CWPF surgery was desirable, with one-third offering it and performing a median of 10 (i.q.r. 5-15) procedures annually. They were more likely to be senior (OR 1.35, 95 per cent c.i. 1.18 to 1.55; P < 0.001), with formal oncoplastic training (OR 4.80, 3.09 to 7.48; P < 0.001), and working in larger units (OR 1.18, 1.03 to 1.35; P = 0.018) with a free-flap (OR 1.62, 1.06 to 2.48; P = 0.025) or CWPF (OR 3.02, 1.87 to 4.89; P < 0.001) service available. In cluster and latent class analysis, none showed high cohesion with performance of CWPF surgery.CONCLUSION: There is a discrepancy between perceived importance and availability of CWPF surgery, indicating that optimal training is needed.

AB - BACKGROUND: Volume replacement using chest wall perforator flaps (CWPFs) is a promising technique to reduce mastectomy rates without sacrificing function or aesthetics. Owing to limited availability of the technique, only a minority of patients currently have access to CWPF procedures.METHODS: An international web-based survey was disseminated through social media, dedicated webpages, and national and international societies for breast surgery. The survey explored surgeons' attitudes towards CWPFs and their perceived training needs.RESULTS: Of 619 respondents, 88.4 per cent agreed that CWPF surgery was desirable, with one-third offering it and performing a median of 10 (i.q.r. 5-15) procedures annually. They were more likely to be senior (OR 1.35, 95 per cent c.i. 1.18 to 1.55; P < 0.001), with formal oncoplastic training (OR 4.80, 3.09 to 7.48; P < 0.001), and working in larger units (OR 1.18, 1.03 to 1.35; P = 0.018) with a free-flap (OR 1.62, 1.06 to 2.48; P = 0.025) or CWPF (OR 3.02, 1.87 to 4.89; P < 0.001) service available. In cluster and latent class analysis, none showed high cohesion with performance of CWPF surgery.CONCLUSION: There is a discrepancy between perceived importance and availability of CWPF surgery, indicating that optimal training is needed.

KW - breast surgery

KW - education

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DO - 10.1093/bjs/znad145

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JO - The British journal of surgery

JF - The British journal of surgery

M1 - e191

ER -

Chest wall perforator flaps for breast reconstruction: international survey on attitudes and training needs

Abstract

Bibliographical note

Data Availability Statement

Keywords

Access to Document

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