Dieterich M, Angres J, Stachs A, Glass A, Reimer T, Gerber B, Stubert J
Breast Unit, Department of Obstetrics and Gynecology, Interdisciplinary Breast Center, University of Rostock, Suedring 81, 18059, Rostock, Germany,
Aesthetic Plast Surg. 2015 Aug;39(4):523-33. doi: 10.1007/s00266-015-0520-x. Epub 2015 Jun 18.
Implant-based breast reconstructions (IBBR) using alternatives to acellular dermal matrixes are increasing. Data on complications are limited, and information concerning health-related quality of life (HR-QoL) following the use of these synthetic meshes do not exist.
Between January 2006 and January 2013, patients undergoing immediate or delayed-immediate IBBR with or without titanium covered polypropylene mesh (TiLOOP® Bra) were investigated. HR-QoL was assessed using the validated self-reporting BREAST-Q questionnaire. Patient demographics and complications were evaluated retrospectively. Stepwise regression backward elimination analysis was performed to identify influential factors on each BREAST-Q domain.
Of the 90 women, 42 had IBBR alone and 48 in combination with TiLOOP® Bra. The mean follow-up was 18 months in the TiLOOP® Bra and 17.5 months in the implant alone group (p = 0.827). The overall complication rate was 21.1 %, with 14.6 % in the TiLOOP® Bra and in 28.6 % in the implant alone group (p = 0.105). Capsular contraction rate was 4.4 % in the TiLOOP® Bra and 16.7 % in the implant alone group (p = 0.052). The analysis of the HR-QoL showed no significant differences between the groups. Surgeries prior to IBBR had a positive influence on HR-QoL. TiLOOP® Bra was associated with a negative effect on "satisfaction with breast" (β = -5.72; p < 0.001), as it was no longer observed for "satisfaction with outcome" and other domains.
使用无细胞真皮基质替代品的植入式乳房重建术（IBBR）正在增加。关于并发症的数据有限，且不存在使用这些合成网片后与健康相关的生活质量（HR-QoL）的信息。
在2006年1月至2013年1月期间，对接受即刻或延迟即刻IBBR且使用或未使用钛涂层聚丙烯网片（TiLOOP® Bra）的患者进行了调查。使用经过验证的自我报告BREAST-Q问卷评估HR-QoL。回顾性评估患者的人口统计学和并发症情况。进行逐步回归向后消除分析以确定每个BREAST-Q领域的影响因素。
90名女性中，42名仅接受了IBBR，48名同时使用了TiLOOP® Bra。TiLOOP® Bra组的平均随访时间为18个月，单纯植入组为17.5个月（p = 0.827）。总体并发症发生率为21.1%，TiLOOP® Bra组为14.6%，单纯植入组为28.6%（p = 0.105）。包膜挛缩率在TiLOOP® Bra组为4.4%，单纯植入组为16.7%（p = 0.052）。HR-QoL分析显示两组之间无显著差异。IBBR之前的手术对HR-QoL有积极影响。TiLOOP® Bra对“乳房满意度”有负面影响（β = -5.72；p < 0.001），而在“结果满意度”和其他领域未再观察到这种情况。
