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胎儿/新生儿牛脱细胞真皮胶原基质(SurgiMend™)在组织扩张器乳房重建中的初步应用经验。

Initial experience with the use of foetal/neonatal bovine acellular dermal collagen matrix (SurgiMend™) for tissue-expander breast reconstruction.

机构信息

The Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

J Plast Reconstr Aesthet Surg. 2013 Sep;66(9):1195-201. doi: 10.1016/j.bjps.2013.05.004. Epub 2013 Jun 13.

Abstract

BACKGROUND

Acellular dermal matrix (ADM) is commonly used in staged breast reconstruction using tissue expanders (TEs). The literature on human ADM has reported variable outcomes, and there is a paucity of data for xenogenic sources of ADM. The aim of this study is to evaluate the early complications, risk factors and outcomes using SurgiMend™ in staged breast reconstruction.

METHODS

An Institutional Review Board (IRB)-approved, retrospective analysis of a single surgeon's experience was performed. From August 2009 to May 2011, 65 patients underwent staged breast reconstruction using 95 sheets of SurgiMend™. The nominal TE fill volume was 383 ± 83 cc (range 250-550), mean intra-operative fill volume was 148 ± 86 cc (range 0-350) and mean final fill volume was 413 ± 176 cc (range 100-800). The mean clinic follow-up time was 16.9 ± 8.7 months; mean age was 50.9 ± 11.7 years; and average body mass index (BMI) was 26.0 ± 5.5 kg m(-2). Correlation with risk factors and clinical outcomes were analysed.

RESULTS

The incidences of postoperative complications were: haematoma 3.2%, seroma 7.5% and re-operation due to infection 2.1%. Age, diabetes mellitus, and hypertension had a significant correlation with an increased overall complication rate. With respect to early complications, such as infection requiring re-operation, diabetes demonstrated a trend with an odds ratio of 11.69.

CONCLUSION

This study demonstrates that the use of SurgiMend™ is associated with low early complication rates and is well tolerated in staged breast reconstruction.

摘要

背景

脱细胞真皮基质(ADM)常用于使用组织扩张器(TE)的分期乳房重建。关于人类 ADM 的文献报道结果不一,而异源来源的 ADM 数据很少。本研究旨在评估使用 SurgiMend 在分期乳房重建中的早期并发症、危险因素和结果。

方法

对一名外科医生的经验进行了机构审查委员会(IRB)批准的回顾性分析。从 2009 年 8 月至 2011 年 5 月,65 例患者使用 95 张 SurgiMend 进行分期乳房重建。标称 TE 填充体积为 383±83cc(范围 250-550),术中平均填充体积为 148±86cc(范围 0-350),最终平均填充体积为 413±176cc(范围 100-800)。平均临床随访时间为 16.9±8.7 个月;平均年龄为 50.9±11.7 岁;平均体重指数(BMI)为 26.0±5.5kg/m²。分析了与危险因素和临床结果的相关性。

结果

术后并发症发生率为:血肿 3.2%,血清肿 7.5%,感染需再次手术 2.1%。年龄、糖尿病和高血压与总并发症发生率增加有显著相关性。就早期并发症(如感染需再次手术)而言,糖尿病的优势比为 11.69,有一定趋势。

结论

本研究表明,使用 SurgiMend 与早期并发症发生率低且在分期乳房重建中耐受性良好相关。

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