Salzberg C Andrew
Department of Surgery-Section of Plastic Surgery, New York Medical College, Valhalla, 10591, USA.
Ann Plast Surg. 2006 Jul;57(1):1-5. doi: 10.1097/01.sap.0000214873.13102.9f.
Immediate breast reconstruction has become a standard of care following mastectomy for cancer, largely due to improved esthetic and psychologic outcomes achieved with this technique. However, the current historical standards--transverse rectus abdominis myocutaneous flap reconstruction and expander--implant surgery-still have limitations as regards patient morbidity, short-term body-image improvements, and even cost. To address these shortcomings, we employ a novel concept of human tissue replacement to enhance breast shape and provide total coverage, enabling immediate mound reconstruction without the need for breast expansion prior to permanent implant placement. AlloDerm (human acellular tissue matrix) is a human-derived graft tissue with extensive experience in various settings of skin and soft tissue replacement surgery. This report describes the success using acellular tissue matrix to provide total coverage over the prosthesis in immediate reconstruction, with limited muscle dissection. In this population, 49 patients (76 breasts) successfully underwent the acellular tissue matrix-based immediate reconstruction, resulting in durable breast reconstruction with good symmetry. These findings may predict that acellular tissue matrix-supplemented immediate breast reconstruction will become a new technique for the immediate reconstruction of the postmastectomy breast.
即刻乳房重建已成为癌症乳房切除术后的一种标准治疗方法，这主要归功于该技术在美学和心理方面取得的改善效果。然而，当前的传统标准——横行腹直肌肌皮瓣重建术和扩张器-植入物手术——在患者发病率、短期身体形象改善甚至成本方面仍存在局限性。为了解决这些缺点，我们采用了一种新型的人体组织替代概念，以改善乳房形状并提供全面覆盖，从而能够在不进行永久植入物放置前乳房扩张的情况下即刻进行乳房隆起重建。AlloDerm（人脱细胞组织基质）是一种源自人体的移植组织，在各种皮肤和软组织替代手术中都有广泛应用经验。本报告描述了在即刻重建中使用脱细胞组织基质为假体提供全面覆盖且肌肉解剖有限的成功案例。在这一群体中，49例患者（76侧乳房）成功接受了基于脱细胞组织基质的即刻重建，实现了持久的乳房重建且对称性良好。这些发现可能预示着脱细胞组织基质辅助的即刻乳房重建将成为乳房切除术后即刻重建的一种新技术。
