Gunnarsson Gudjon Leifur, Børsen-Koch Mikkel, Arffmann Susanne, Guldvog Ivar, Wamberg Peter, Kjær Christina, Westvik Tormod, Thomsen Jørn Bo
Plastikkirurgisk Afdeling Z, Vejle Sygehus, Kabbeltoft 25, 7100 Vejle, Denmark.
Dan Med J. 2013 Dec;60(12):A4751.
We present Scandinavia's first series of immediate alloplastic breast reconstructions with an acellular dermal matrix.
Data were collected retrospectively in 76 cases of immediate breast reconstruction using an acellular dermal matrix (ADM) and an implant.
A total of 59 women were reconstructed between June 2011 and January 2013. Cases included 42 unilateral and 17 bilateral reconstructions. A large number of patients had adjuvant therapy, hormone therapy (34), radiation therapy (27) or chemotherapy (38). The median age was 51 years (30-70 years) and the median follow-up period was 326 days (68-624 days). The co-morbidity factors included hypertension (n = 11), diabetes (n = 2) and 19 patients were smokers. Unsuccessful reconstructions counted ten cases (13%), eight of these due to necrosis and/or wound dehiscence (10%) and two due to infection (3%). The failure rate in non-smokers was 2/52 (4%) compared with 8/24 (33%) in smokers, p = 0.001. In hypertensive patients, the failure rate was 6/12 (50%) compared with 4/64 (6%)in normotensive patients, p = 0.001. 70% of the failed reconstructions occurred in patients older than 65 years of age.
Immediate alloplastic breast reconstruction using an ADM can be recommended to healthy non-smoking patients.
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我们展示了斯堪的纳维亚半岛首例使用脱细胞真皮基质进行即刻异体乳房重建的系列病例。
回顾性收集了76例使用脱细胞真皮基质(ADM)和植入物进行即刻乳房重建的病例数据。
2011年6月至2013年1月期间,共为59名女性进行了乳房重建。病例包括42例单侧和17例双侧重建。大量患者接受了辅助治疗、激素治疗(34例)、放射治疗(27例)或化疗(38例)。中位年龄为51岁(30 - 70岁),中位随访期为326天(68 - 624天)。合并症因素包括高血压(n = 11)、糖尿病(n = 2),19名患者为吸烟者。重建失败的病例有10例(13%),其中8例因坏死和/或伤口裂开(10%),2例因感染(3%)。非吸烟者的失败率为2/52(4%),而吸烟者为8/24(33%),p = 0.001。高血压患者的失败率为6/12(50%),血压正常患者为4/64(6%),p = 0.001。70%的重建失败发生在65岁以上的患者中。
对于健康的非吸烟患者,推荐使用ADM进行即刻异体乳房重建。
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