Division of Plastic Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA; The Center for Clinical Research Informatics, NorthShore University HealthSystem, Evanston, IL, USA.
J Plast Reconstr Aesthet Surg. 2014 Oct;67(10):1345-51. doi: 10.1016/j.bjps.2014.05.032. Epub 2014 May 28.
Use of human acellular dermal matrix (ADM) during prosthetic breast reconstruction has increased. Several ADM products are available produced by differing manufacturing techniques. It is not known if outcomes vary with different products. This study reports the complication prevalence following use of a tutoplast-derived ADM (T-ADM) in prosthetic breast reconstruction. We performed a retrospective chart review of 203 patients (mean follow-up times 12.2 months) who underwent mastectomy and immediate prosthetic breast reconstruction utilizing T-ADM, recording demographic data, surgical indications and complication (infection, seroma, hematoma, wound healing exceeding three weeks and reconstruction failure). During a four-year period, 348 breast reconstructions were performed Complications occurred in 16.4% of reconstructed breasts. Infection occurred in 6.6% of breast reconstructions (3.7% - major infection, requiring intravenous antibiotics and 2.9% minor infection, requiring oral antibiotics only). Seromas occurred in 3.4% and reconstruction failure occurred in 0.6% of breast reconstructions. Analysis suggested that complication prevalence was significantly higher in patients with a BMI >30 (p = 0.03). The complication profile following T-ADM use is this series is comparable to that reported for with other ADM products. T-ADM appears to be a safe and acceptable option for use in ADM-assisted breast reconstruction.
使用脱细胞真皮基质(ADM)进行假体乳房重建的情况有所增加。有几种 ADM 产品可用于不同的制造技术。目前尚不清楚不同产品的结果是否存在差异。本研究报告了使用 tutoplast 衍生 ADM(T-ADM)进行假体乳房重建后的并发症发生率。我们对 203 名患者(平均随访时间 12.2 个月)进行了回顾性图表审查,这些患者接受了乳房切除术和即刻假体乳房重建,记录了人口统计学数据、手术指征和并发症(感染、血清肿、血肿、伤口愈合超过三周和重建失败)。在四年期间,进行了 348 次乳房重建,16.4%的重建乳房出现并发症。感染发生在 6.6%的乳房重建中(3.7%为严重感染,需要静脉内抗生素治疗,2.9%为轻度感染,仅需口服抗生素治疗)。血清肿发生率为 3.4%,重建失败发生率为 0.6%。分析表明,BMI 大于 30 的患者并发症发生率显著更高(p=0.03)。在本系列中,T-ADM 使用后的并发症谱与其他 ADM 产品报告的结果相似。T-ADM 似乎是 ADM 辅助乳房重建中安全且可接受的选择。