Breast Unit, Royal Hampshire County Hospital, Winchester, SO22 5DG, UK.
Breast. 2012 Dec;21(6):764-8. doi: 10.1016/j.breast.2012.03.007. Epub 2012 Apr 10.
Single-stage reconstruction using permanent expander implants is an established technique following mastectomy. Short and long-term outcome data following breast reconstruction using Becker tissue expanders is limited.
A retrospective case note review of patients undergoing expander-based procedures between 1989 and 2007 was undertaken. Data recorded included postoperative symptoms and complications, the use of radiotherapy, revisional surgery, and device failure.
Three hundred and thirteen expanders were used in 276 patients with a mean age of 48.3 (17-78) years, over the 18 year study period. The mean follow up period was 64.6 (1-199) months. 256 Becker expanders were used during 175 latissimus dorsi (LD) and 52 subpectoral (SP) reconstructions, 13 contralateral augmentations and 16 implant replacements. The postoperative infection rate was 5.8%, leading to an expander loss rate of 3.8%. The use of prophylactic antibiotics was associated with an increased postoperative infection rate (p = 0.046). Six haematomas (2.5%) and 12 cases of skin envelope necrosis (5.0%) required unscheduled intervention. Symptoms of pain, distortion and hardness were experienced by 21.3% of patients, and radiotherapy was associated with a significantly higher risk of adverse symptoms (p < 0.0001). No patient developed symptomatic implant rupture or silicone granuloma but 17.9% of reconstructions underwent revisional surgery, the rate being highest following SP reconstruction (p = 0.029). Nine patients developed injection port complications (3.8%), and the overall device failure rate was 1.3%. The original expander has been retained by 74.2% of women.
The Becker permanent expander is a reliable implant associated with a low complication rate and a high retention rate when used during breast reconstruction.
乳房切除术后，使用一次性扩张器植入物进行一期重建是一种已确立的技术。使用 Becker 组织扩张器进行乳房重建后的短期和长期结果数据有限。
对 1989 年至 2007 年间接受扩张器手术的患者进行回顾性病历回顾。记录的数据包括术后症状和并发症、放疗的使用、修正手术和设备故障。
在 18 年的研究期间，313 个扩张器在 276 名平均年龄为 48.3（17-78）岁的患者中使用。平均随访时间为 64.6（1-199）个月。在 175 例背阔肌（LD）和 52 例胸肌下（SP）重建、13 例对侧增强和 16 例植入物更换中使用了 256 个 Becker 扩张器。术后感染率为 5.8%，导致扩张器丢失率为 3.8%。预防性使用抗生素与术后感染率增加相关（p = 0.046）。6 例血肿（2.5%）和 12 例皮肤包膜坏死（5.0%）需要非计划干预。21.3%的患者出现疼痛、变形和硬度症状，放疗与不良症状的发生风险显著增加（p < 0.0001）。无患者出现症状性植入物破裂或硅胶肉芽肿，但 17.9%的重建术需要修正手术，SP 重建术的发生率最高（p = 0.029）。9 例患者出现注射端口并发症（3.8%），总设备故障发生率为 1.3%。74.2%的女性保留了原始扩张器。
Becker 永久性扩张器是一种可靠的植入物，在乳房重建中使用时并发症发生率低，保留率高。
