Collis George N, TerKonda Sarvam P, Waldorf James C, Perdikis Galen
Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Ann Plast Surg. 2012 May;68(5):425-8. doi: 10.1097/SAP.0b013e318225833f.
Acellular dermal matrix (ADM) slings in breast reconstruction are increasingly used but are not yet validated. This study compares immediate, expander-based breast reconstruction with and without the use of inferolateral ADM slings. There were 63 patients (106 breasts) in the ADM group and 42 patients (68 breasts) in the control group. Initial intraoperative fill volumes were significantly greater in the ADM group, median 69% full (250 mL) versus 50% full (180 mL; P < 0.001). However, the number of days to complete expansion between the 2 groups was similar. One less office visit was required to complete the fills in the ADM group (P < 0.01). Drains were removed 3 days later in the ADM group (P < 0.01). Overall complication rate was greater in the ADM group (18.9% vs. 7.4%, P < 0.05), with a slightly higher percentage of expanders requiring removal due to infection in the ADM group (5.7% vs. 4.4%, P = NS). This study suggests inferolateral ADM slings in expander-based breast reconstruction allow for significantly increased initial fill volumes and may offer an aesthetic advantage; however, its use is costly and increases complications.
脱细胞真皮基质（ADM）吊带在乳房重建中的应用日益广泛，但尚未得到验证。本研究比较了使用和不使用下外侧ADM吊带进行即刻扩张器乳房重建的情况。ADM组有63例患者（106侧乳房），对照组有42例患者（68侧乳房）。ADM组术中初始填充量显著更大，中位数为充盈69%（250 mL），而对照组为充盈50%（180 mL；P<0.001）。然而，两组完成扩张所需的天数相似。ADM组完成填充所需的门诊就诊次数少1次（P<0.01）。ADM组引流管在术后3天拔除（P<0.01）。ADM组的总体并发症发生率更高（18.9%对7.4%，P<0.05），ADM组因感染需要取出扩张器的比例略高（5.7%对4.4%，P=无统计学意义）。本研究表明，在扩张器乳房重建中使用下外侧ADM吊带可显著增加初始填充量，并可能具有美学优势；然而，其使用成本高昂且会增加并发症。
