Washington, D.C. From the Department of Plastic Surgery, Georgetown University Hospital.
Plast Reconstr Surg. 2013 May;131(5):1140-1148. doi: 10.1097/PRS.0b013e3182865d0c.
Although acellular dermal matrix materials have been in use for over a decade in primary and secondary breast reconstruction and in some cosmetic breast surgery, little has been published on the outcomes of these materials for cosmetic applications.
A retrospective institutional review board-approved review was conducted of all patients who had a specific acellular dermal matrix, Strattice, used for cosmetic breast surgery performed by the senior author (S.L.S.). Patient demographics, indications, surgical findings, and postoperative course were collected and data analyzed using descriptive statistical tools.
Between 2008 and 2012, Strattice was used in 43 cosmetic breast operations (75 breasts) performed by the senior author (S.L.S.). Sixty-nine of the 75 breasts (92 percent) were revision operations. Indications included inferior pole support [39 breasts (52 percent)], fold malpositions [28 breasts (37 percent)], capsular contracture [25 breasts (33 percent)], and rippling/palpability [six breasts (8 percent)]. Three patients (six breasts) had Strattice placed during primary augmentation/mastopexy. Seventy-four of the 75 breasts (98.7 percent) had successfully achieved the indication for which the Strattice was placed; one breast (1.2 percent) had some degree of relapse. The global complication rate for all patients in this study is 5.3 percent-two breasts (2.7 percent) had postoperative malposition, one breast (1.2 percent) had bottoming out, and one breast (1.2 percent) developed an infection that resulted in temporary device explantation.
The use of Strattice is safe and may be helpful in the management of certain situations in cosmetic breast surgery, including needed lower pole support, capsular contracture, rippling, and implant malposition.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
尽管脱细胞真皮基质材料在一级和二级乳房重建以及某些美容乳房手术中已经使用了十多年，但对于这些材料在美容应用中的效果，发表的内容很少。
对所有由高级作者 (S.L.S.) 进行的特定脱细胞真皮基质 Strattice 用于美容乳房手术的患者进行了回顾性机构审查委员会批准的回顾。收集了患者的人口统计学资料、适应证、手术发现和术后过程，并使用描述性统计工具进行数据分析。
在 2008 年至 2012 年间，高级作者 (S.L.S.) 在 43 例美容乳房手术（75 只乳房）中使用了 Strattice。75 只乳房中有 69 只乳房（92%）为翻修手术。适应证包括下极支撑 [39 只乳房（52%）]、折叠错位 [28 只乳房（37%）]、包膜挛缩 [25 只乳房（33%）] 和波纹/可触性 [6 只乳房（8%）]。有 3 名患者（6 只乳房）在初次隆胸/乳房提升术时放置了 Strattice。75 只乳房中有 74 只乳房（98.7%）成功实现了放置 Strattice 的适应证；1 只乳房（1.2%）有一定程度的复发。本研究中所有患者的总体并发症发生率为 5.3%--2 只乳房（2.7%）出现术后错位，1 只乳房（1.2%）出现底部外露，1 只乳房（1.2%）发生感染，导致临时装置取出。
Strattice 的使用是安全的，并且在美容乳房手术中某些情况下可能有助于管理，包括需要下极支撑、包膜挛缩、波纹和植入物错位。
临床问题/证据水平：治疗，IV。
