Disability evaluation after latissimus dorsi muscle transfer in breast reconstruction using DASH score

Jazmin V. Sanchez; Rene R. Guerrero; Karla F. G. G. Rubio; Noe I. G. Mancilla; Raymundo T. Piña

doi:10.18203/2320-6012.ijrms20241612

Authors

Jazmin V. Sanchez Department of Plastic and Reconstructive Surgery, Hospital General de México “Dr. Eduardo Liceaga”, México City, México
Rene R. Guerrero Department of Plastic and Reconstructive Surgery, Hospital General de México “Dr. Eduardo Liceaga”, México City, México
Karla F. G. G. Rubio Department of Plastic and Reconstructive Surgery, Hospital General de México “Dr. Eduardo Liceaga”, México City, México
Noe I. G. Mancilla Department of Plastic and Reconstructive Surgery, Hospital General de México “Dr. Eduardo Liceaga”, México City, México
Raymundo T. Piña Department of Plastic and Reconstructive Surgery, Hospital General de México “Dr. Eduardo Liceaga”, México City, México

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241612

Keywords:

Breast reconstruction, Muscular flap, Disability, DASH

Abstract

Background: Breast reconstruction with latissimus dorsi muscle transfer is one of the most frequent procedures at our hospital. The objective is to evaluate if there is any functional impairment after the surgery with a potential impact of patient´s daily life.

Methods: Functional morbidity was analyzed applying the disabilities of the arm, shoulder and hand (DASH) questionnaire and shoulder range of motion with goniometer in 42 patients whose breast reconstruction was between 2016 and 2022 at our hospital. We collected data using Microsoft excel V16.47.1 and analyzed data with statistical package for the social sciences (SPSS) software, v23.0.

Results: There was statistically significant difference for disability/symptom DASH score in cases of bilateral reconstruction and for cases undergoing a procedure on the right side versus left side.

Conclusions: In patients with bilateral breast reconstruction, we found a greater DASH score in dysfunction and symptoms which associates with poor quality of life, as well as when the flap is on the contralateral extremity of the hand dominance; in those cases, there are other reconstructive procedures that provide greater safety and less disability to the patient. For evaluating extension, we need more prospective and comparative studies with strict follow up of the patients and same series of rehabilitation.

Metrics

Metrics Loading ...

References

Mohar A, Paredes A, Brau-Figueroa H, Sánchez A, Palafox A, Rivera-Gómez R, et al. Implementation of a population-based cancer registry network in Mexico 2017-2020. Salud Publica Mex. 2023;66(1):104-12.

Martínez-Martínez GC, Ramírez-Guerrero R, Moreno-Hernández SG, Hernández-Campos AM, Mejía-Rivera SE, Torres-Piña R. Incidence of complications in breast reconstruction with autologous tissue in a third level hospital. Int J Res Med Sci. 2023;11(7):2396-400.

Salles JI, Velasques B, Cossich V, Nicoliche E, Ribeiro P, Amaral MV, et al. Strength training and shoulder proprioception. J Athl Train. 2015;50(3):277-80.

Lugo R, Kung P, Ma CB. Shoulder biomechanics. Eur J Radiol. 2008;68(1):16-24.

Puentes Gutiérrez AB, García Bascones M, Jiménez Díaz F, Cuena Boy R, Puentes Gutiérrez R. Validity and reliability of DASH questionnaire in women who suffer from lymphedema as a side effect of a breast cancer treatment. Rehabilitacion (Madr). 2023;57(3):100780.

Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheumatism. 2009;61(5):623-32.

Zehra S, Doyle F, Barry M, Walsh S, Kell MR. Health-related quality of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: a systematic review and meta-analysis. Breast Cancer. 2020;27(4):534-66.

Glassey N, Perks GB, McCulley SJ. A Prospective Assessment of Shoulder Morbidity and Recovery Time Scales Following Latissimus Dorsi Breast Reconstruction. Plast Reconstruct Surg. 2008;122(5):1334-40.

Russo SA, Chafetz RS, Rodriguez LM, Roposh CM, Zlotolow DA, Kozin SH, et al. Comparison of shoulder motion measurements by visual estimate, goniometer and motion capture. J Pediatric Orthopaed. 2022;42(8):443-50.

Lee KT, Mun GH. A systematic review of functional donor-site morbidity after latissimus dorsi muscle transfer. Plast Reconstruct Surg. 2014;134(2):303-14.

Doan L, Sam AP, Li WY. Optimizing the Pedicled Latissimus Dorsi Myocutaneous Flap in Breast Reconstruction: Lessons Learned from 110 Consecutive Flaps. Plastic and Reconstructive Surgery–Global Open. 2024;12(5):e5791.

Park E, Lee JS, Park HY, Yang JD, Jung TD. Effect of Serial Home-Based Exercise Immediately after Latissimus Dorsi Reconstruction in Patients with Breast Cancer. Healthcare. 2022;10(9):1760.

Harrington S, Michener LA, Kendig T, Miale S, George SZ. Patient-reported upper extremity outcome measures used in breast cancer survivors: a systematic review. Arch Phys Med Rehab. 2014;95(1):153-62.