Bindingnavele Vijay, Gaon Mark, Ota Ken S, Kulber David A, Lee Dong-Joon
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Southern California, Los Angeles, CA, USA.
J Plast Reconstr Aesthet Surg. 2007;60(11):1214-8. doi: 10.1016/j.bjps.2007.03.015. Epub 2007 Apr 25.
Tissue expander or permanent implant coverage in postmastectomy breast reconstruction is often challenging. Multiple authors have demonstrated the use of acellular cadaveric dermis (ACD) in nonexpansive, single-stage breast reconstruction. The literature also suggests that tissue expansion may be accomplished with ACD as well for stage reconstructions. In many cases tissue expansion is necessary to create a submuscular and subACD pocket to accommodate a subsequent permanent prosthesis. In this study we report the outcomes and complication rates of using ACD in staged breast reconstruction. We reviewed the charts of 41 patients (65 breasts) in whom ACD was used in staged reconstructions. We analysed the patients' charts and operative records to determine postoperative complication rates and results. Complication rates for wound infection, expander removal, haematoma, and seroma were: 3.1% (two of 65), 1.5% (one of 65), 1.5% (one of 65), and 4.6% (three of 65), respectively. The use of ACD in expansive postmastectomy breast reconstruction has an extremely low complication rate, results in good cosmetic outcome, and should be in the repertoire of plastic surgeons. Further follow up is needed to evaluate the long term outcomes of ACD use in postmastectomy breast reconstruction.
在乳房切除术后乳房重建中，使用组织扩张器或永久性植入物进行覆盖往往具有挑战性。多位作者已证明在非扩张性单阶段乳房重建中使用脱细胞尸体真皮（ACD）。文献还表明，对于分期重建，也可使用ACD进行组织扩张。在许多情况下，需要进行组织扩张以创建一个肌下和ACD下的腔隙，以容纳后续的永久性假体。在本研究中，我们报告了在分期乳房重建中使用ACD的结果和并发症发生率。我们回顾了41例（65个乳房）在分期重建中使用ACD的患者病历。我们分析了患者的病历和手术记录，以确定术后并发症发生率和结果。伤口感染、扩张器取出、血肿和血清肿的并发症发生率分别为：3.1%（65例中的2例）、1.5%（65例中的1例）、1.5%（65例中的1例）和4.6%（65例中的3例）。在扩张性乳房切除术后乳房重建中使用ACD的并发症发生率极低，美容效果良好，应成为整形外科医生的技术储备。需要进一步随访以评估在乳房切除术后乳房重建中使用ACD的长期效果。
