Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea.
Aesthetic Plast Surg. 2014 Feb;38(1):139-145. doi: 10.1007/s00266-013-0232-z. Epub 2013 Nov 21.
Late seroma is an infrequent complication that manifests as fluid collection in the periprosthetic space at least 1 year after breast enlargement surgery. Interest in late seroma has grown with the potential connection between breast implants and anaplastic large cell lymphoma (ALCL), which presents with clinical symptoms similar to those of late seroma. This report presents a case of late seroma experienced by a patient with a history of multiple implant ruptures and a review of the relevant literature.
Details are reported for a patient who presented with sudden swelling of an augmented breast that was initially suspected to be symptomatic of ALCL. A literature search of PubMed regarding this phenomenon also was conducted.
The literature review identified 14 articles on late seroma involving 60 patients, including the reported case. Analyses included epidemiology, etiology, and management strategy. Although a detailed statistical analysis was not performed, 55 cases (92 %) of late seroma occurred that involved patients with textured implants. No evidence-based guideline for the management of late seroma has been established, although the patients were managed successfully in all cases using various strategies.
The reported case and data from the literature provide evidence of a relationship between textured implant use and late seroma. Based on their review, the authors offer "sequential treatment steps," from conservative treatment to surgical management, which will be helpful for successful management of future late seroma cases. However, further study is needed to clarify the relationship, if any, between a particular type of textured implant and the development of late seroma.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
迟发性血清肿是一种罕见的并发症，表现为乳房增大手术后至少 1 年在假体周围空间出现液体积聚。由于乳房植入物与间变性大细胞淋巴瘤（ALCL）之间存在潜在联系，人们对迟发性血清肿的兴趣日益增加，后者的临床表现与迟发性血清肿相似。本报告介绍了一例既往多次假体破裂史的患者出现迟发性血清肿的病例，并对相关文献进行了回顾。
详细介绍了一例因假体破裂史而出现突发乳房肿胀的患者，最初怀疑为 ALCL 症状。还对 PubMed 上关于该现象的文献进行了检索。
文献回顾共纳入 14 篇关于迟发性血清肿的文章，涉及 60 例患者，包括本报告病例。分析包括流行病学、病因和管理策略。尽管未进行详细的统计学分析，但 55 例（92%）迟发性血清肿发生于使用粗糙表面假体的患者中。尽管没有建立针对迟发性血清肿的循证管理指南，但通过各种策略成功管理了所有病例。
本报告病例和文献数据提供了粗糙表面假体使用与迟发性血清肿之间存在关联的证据。作者根据文献回顾提出了“序贯治疗步骤”，从保守治疗到手术管理，这将有助于成功管理未来的迟发性血清肿病例。然而，需要进一步研究以明确特定类型的粗糙表面假体与迟发性血清肿发展之间的关系（如果存在的话）。
证据等级 V：本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
