Rotterdam, The Netherlands; and Toronto, Ontario, Canada From the Departments of Plastic and Reconstructive Surgery and Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center, and the Division of Plastic Surgery, University Health Network, University of Toronto.
Plast Reconstr Surg. 2010 Jul;126(1):26-36. doi: 10.1097/PRS.0b013e3181da87a6.
The majority of breast reconstructions are performed using implant material. Implants have some major long-term disadvantages. Long-term implant-related complications and improved microsurgical techniques have led to an increased number of women requesting conversion of their implant breast reconstruction to autologous breast reconstruction. The aim of this study was to evaluate surgical and aesthetic outcome and patient satisfaction after tertiary autologous breast reconstruction.
Between 2001 and 2007, 42 women underwent 61 tertiary autologous breast reconstructions. Surgical outcome and complications were evaluated. Patient satisfaction was assessed using a study-specific questionnaire. Aesthetic result was rated by an expert panel using standardized photographs.
Forty-seven deep inferior epigastric artery perforator, 10 mini-transverse rectus abdominis musculocutaneous, and four transverse musculocutaneous gracilis flaps were performed. Eight patients required reoperation because of complications (19 percent). Total flap loss did not occur. Nineteen patients underwent one or more additional operations to improve aesthetic outcome. Physical discomfort caused by implants and dissatisfaction with the aesthetic result were the main patient motivations to opt for autologous breast reconstruction. Reduction or disappearance of physical discomfort was noted in the vast majority of patients. Most patients were very satisfied with the aesthetic result (mean, 8 of 10), but the mean panel satisfaction score was lower (7 of 10). However, the panel noted a significant improvement of the aesthetic result after conversion to autologous breast reconstruction (from 5 of 10 to 7 of 10).
Autologous breast reconstruction after failed implant reconstruction is a technically feasible and reliable procedure that leads to improved physical condition and aesthetic results and a high degree of patient satisfaction.
大多数乳房重建术采用植入物材料完成。植入物存在一些主要的长期缺点。长期的植入物相关并发症和改进的显微外科技术导致越来越多的女性要求将其植入物乳房重建转换为自体乳房重建。本研究的目的是评估三级自体乳房重建后的手术和美学效果及患者满意度。
2001 年至 2007 年间，42 名女性接受了 61 例三级自体乳房重建。评估手术结果和并发症。使用特定于研究的问卷评估患者满意度。使用标准化照片由专家小组评估美学结果。
47 例腹壁下动脉穿支皮瓣、10 例迷你横向腹直肌肌皮瓣和 4 例横行肌皮瓣游离移植。由于并发症，8 例患者需要再次手术（19%）。未发生总瓣坏死。19 例患者因改善美学效果而行一次或多次附加手术。因植入物引起的身体不适和对美学效果的不满是患者选择自体乳房重建的主要原因。绝大多数患者报告身体不适减轻或消失。大多数患者对美学效果非常满意（平均 10 分中的 8 分），但专家组的平均满意度评分较低（10 分中的 7 分）。然而，专家组注意到自体乳房重建后美学效果显著改善（从 10 分中的 5 分提高到 10 分中的 7 分）。
失败的植入物重建后的自体乳房重建是一种技术可行且可靠的手术方法，可改善身体状况和美学效果，并获得高度的患者满意度。
Zotero 插件