Department of Obstetrics and Gynecology, Breast Unit, University of Rostock, Interdisciplinary Breast Center, Suedring 81, 18059 Rostock, Germany.
Eur J Surg Oncol. 2012 Dec;38(12):1225-30. doi: 10.1016/j.ejso.2012.08.026. Epub 2012 Sep 13.
A new approach for implant based breast reconstruction (IBBR) is the use of a titanium-coated polypropylene mesh (TCPM) as an alternative to acellular dermal matrix (ADM). This TCPM has a good biocompatibility and can be used similarly to ADM. The aim of this study is to discuss indications, limitations and complications of TCPM in IBBR.
A retrospective analysis of 42 patients undergoing immediate or delayed IBBR using a TCPM was performed. Primary endpoints were incidence of infection and expander/implant with mesh removal due to infected fluid collection or extrusion.
In two patients, mild hematoma, seroma or infection occurred. Skin necrosis or capsular contraction was observed in one patient. Mesh explantation was needed in 3 cases. These events were higher among the first cases and in patients with postoperative skin infection (p = 0.003).
In selected patients with adequate soft tissue cover TCPM seems to be a helpful tool for implant stabilization in terms of lateral stabilization and fixation of the musculus pectoralis major. In comparison to ADM, TCPM is cheaper and initial results are promising, but further follow-up data are necessary. In patients with poor soft tissue cover ADM should be used.
一种新的基于植入物的乳房重建(IBBR)方法是使用钛涂层聚丙烯网(TCPM)作为去细胞真皮基质(ADM)的替代品。这种 TCPM 具有良好的生物相容性,可以与 ADM 类似地使用。本研究旨在讨论 TCPM 在 IBBR 中的适应证、局限性和并发症。
对 42 例接受 TCPM 即刻或延迟 IBBR 的患者进行回顾性分析。主要终点是因感染性积液或挤出而发生感染和扩张器/植入物去除的发生率。
2 例患者出现轻度血肿、血清肿或感染。1 例患者出现皮肤坏死或包膜挛缩。3 例需要取出网片。这些事件在首例患者和术后皮肤感染患者中发生率更高(p = 0.003)。
在具有足够软组织覆盖的选定患者中,TCPM 似乎是一种有助于植入物稳定的工具,可用于外侧稳定和胸大肌的固定。与 ADM 相比,TCPM 更便宜,初步结果有希望,但需要进一步的随访数据。在软组织覆盖不良的患者中应使用 ADM。