基于植入物的双侧乳房重建中使用脱细胞真皮基质相关的感染并发症。
Infectious complications associated with the use of acellular dermal matrix in implant-based bilateral breast reconstruction.
作者信息
Hill Joseph L, Wong Lesley, Kemper Pamela, Buseman Jason, Davenport Daniel L, Vasconez Henry C
机构信息
Division of Plastic Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
出版信息
Ann Plast Surg. 2012 May;68(5):432-4. doi: 10.1097/SAP.0b013e31823b6ac6.
BACKGROUND
The use of acellular dermal matrix (ADM) has become a routine practice in implant-based breast reconstruction. Bilateral mastectomy is becoming more popular in cases of unilateral breast cancer. ADM has been associated with an increased incidence of complications.
METHODS
We identified cases of bilateral implant-based breast reconstruction over a 5-year period. Data collection included medical comorbities, details of operative management, and details of postoperative cancer treatment.
RESULTS
On univariate analysis, the use of ADM (31% vs. 7%, P = 0.018), smoking (37% vs. 13%, P = 0.045), and open wound (55% vs. 13%, P = 0.006) were significantly associated with increased risk of infection. Multivariate analysis revealed open wound as the strongest predictor of infection.
CONCLUSIONS
The use of ADM is associated with an increased risk of infection in bilateral implant-based breast reconstruction. However, it does not appear to be an independent risk factor by itself.
背景
脱细胞真皮基质（ADM）的使用已成为基于植入物的乳房重建中的常规操作。双侧乳房切除术在单侧乳腺癌病例中越来越普遍。ADM与并发症发生率增加有关。
方法
我们确定了5年内双侧基于植入物的乳房重建病例。数据收集包括医疗合并症、手术管理细节和术后癌症治疗细节。
结果
单因素分析显示，使用ADM（31%对7%，P = 0.018）、吸烟（37%对13%，P = 0.045）和开放性伤口（55%对13%，P = 0.006）与感染风险增加显著相关。多因素分析显示开放性伤口是感染的最强预测因素。
结论
在双侧基于植入物的乳房重建中，ADM的使用与感染风险增加有关。然而，它本身似乎不是一个独立的风险因素。
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