Improving Tissue Oxygenation in Breast Reconstruction Surgery
Status:
Recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
Breast reconstruction is an integral part of breast cancer care. There are two main types of
breast reconstruction: alloplastic (using implants), and autologous (using patient's tissue).
The latter creates a more natural breast mound, and avoids long-term concerns requiring
surgical re-intervention associated with implant-based surgery. The deep inferior epigastric
perforator (DIEP) flap is the gold standard technique in autologous breast reconstruction.
Complications that do occur with DIEP flap surgery often stem from poor flap
perfusion/oxygenation. Hence, the development of strategies to enhance flap perfusion (e.g.,
optimal perioperative fluid therapy) is essential. Current perioperative fluid therapy is
usually guided by subjective criteria which leads to wide variations in fluids administered.
We will randomly assign DIEP flap patients to receive optimal (cardiac output-guided) fluid
therapy in combination with dobutamine (a medication which has potential to improve flap
oxygenation) versus the current standard of care. Flap oxygenation will be monitored in all
patients for up to 48 hours postoperatively. Optimal fluid therapy in combination with
dobutamine may improve flap oxygenation and thereby, reduce complications.