DIEP Flap Breast Reconstruction: Perioperative Biomarkers and Outcomes

NCT ID: NCT07263347

Last Updated: 2025-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-12-31

Study Completion Date

2026-10-31

Brief Summary

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Brief Summary This observational study will follow patients who undergo DIEP flap breast reconstruction to better understand a common surgical challenge called ischemia-reperfusion (I/R) injury. I/R injury can happen when a flap has a period without blood flow (ischemia) and then blood flow returns (reperfusion). This process may trigger inflammation and oxidative stress and is associated with fat necrosis or partial flap loss.

1\. What is being studied

1. The investigators will measure inflammation and oxidative stress markers in blood (for example, interleukin-6 \[IL-6\]) from before surgery through the first 72 hours after surgery.
2. These data will help map the normal and abnormal patterns of recovery after surgery and may inform future approaches to monitoring and protecting flap tissue.
3. No experimental drug or device is given to participants in this study. Separate animal studies are developing a near-infrared imaging and antioxidant nanomaterial (Mn/QD-SAC); this is not used in participants here.

2\. Who can take part

1. Women aged 18-70 scheduled for immediate DIEP flap breast reconstruction after breast cancer surgery.
2. Key exclusions include severe heart, liver, or kidney disease; significant clotting problems; active infection or autoimmune disease; long-term use of immunosuppressants/anti-inflammatory drugs; pregnancy or breastfeeding; or other reasons judged by the research team.

3\. What will happen if you join

1. After providing informed consent, participants will have blood drawn at five time points: pre-operative baseline (within 24 hours before surgery) and at 0, 6, 24, and 72 hours after surgery (about 10 mL each time; total \~50 mL).
2. Blood will be processed and stored under secure conditions and tested for inflammation and oxidative stress markers.
3. The investigators will also record routine clinical information from the medical record (such as age, BMI, surgery duration, ischemia time, and clinical assessments of flap outcomes and complications).
4. Participation does not change the participant's clinical care before, during, or after surgery.

4\. Risks and benefits

1. Risks are those of standard blood draws: brief pain, bruising, bleeding, dizziness, and rare infection.
2. There is no direct medical benefit to participants. Results may help improve understanding and future care for patients undergoing flap reconstruction.

5\. Privacy and data protection

1. Samples and data will be coded without names. Identifying information is stored separately with restricted access.
2. Research results are not routinely added to the medical record or returned to participants unless a finding has clear, actionable clinical significance and is approved by the ethics committee.

6\. Time commitment and costs

1. All blood draws occur during the routine hospital stay. There is no additional follow-up required after discharge.
2. There is no cost to participate.

7\. Voluntary participation Joining the study is voluntary. Participants may withdraw at any time without affecting their medical care.

Detailed Description

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Conditions

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Ischemia-Reperfusion Injury Postoperative Complications Wound Healing Oxidative Stress Inflammation Breast Neoplasms

Keywords

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Deep inferior epigastric perforator (DIEP) flap Autologous breast reconstruction Free tissue transfer Ischemia-reperfusion injury

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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DIEP flap reconstruction patients (longitudinal peripheral blood cohort)

Prospective observational cohort of women (18-70 years) undergoing immediate autologous breast reconstruction with a DIEP free flap. Standard peri-operative care only; no investigational imaging or drug (no Mn/QD-SAC) is administered. Serial peripheral blood is collected at pre-op baseline (≤24 h) and at 0 h, 6 h, 24 h, and 72 h post-op (≈10 mL/timepoint; serum + EDTA plasma). Primary measurement is plasma IL-6; additional analytes include IL-1β, TNF-α, IL-8, IL-10, IL-18, HMGB1, vWF, VEGF, HIF-1α, MDA, 8-iso-PGF2α, SOD, CAT, GSH-Px, lactate, LDH, PT/APTT/fibrinogen, D-dimer, and CBC. Samples are processed within 2 h and stored at -80°C for batch ELISA/biochemical assays. Clinical data (age, BMI, operative/ischemia times, flap perfusion assessments, complications, fat necrosis/partial flap loss) are recorded. Target enrollment \~30 participants.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. Female, 18-70 years old.
2. Clinically diagnosed with breast cancer and scheduled for immediate DIEP free-flap breast reconstruction after mastectomy.
3. Conscious and able to understand and voluntarily sign written informed consent.

Exclusion Criteria

1. Severe cardiac, hepatic, or renal dysfunction or severe coagulopathy (e.g., NYHA class III-IV, Child-Pugh class C, eGFR \<30 mL/min/1.73 m²).
2. Preoperative active infection, autoimmune disease, or long-term use of immunosuppressants/anti-inflammatory drugs (e.g., corticosteroids).
3. Pregnant or breastfeeding.
4. Prior ipsilateral breast surgery or radiotherapy that may affect local blood circulation assessment.
5. Any condition deemed unsuitable by the investigator (e.g., poor compliance).
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Hubei Cancer Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xinhong Wu, PhD

vice-president

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hubei Cancer Hospital

Wuhan, Hubei, China

Site Status

Countries

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China

Central Contacts

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Xinhong Wu Principal Investigator

Role: CONTACT

Phone: 18602726300

Email: [email protected]

Facility Contacts

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Wu Xinhong

Role: primary

Xinhong Wu

Role: backup

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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LLHBCH2025YN-075

Identifier Type: -

Identifier Source: org_study_id