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使用无菌脱细胞真皮基质对基于植入物的即刻乳房重建并发症发生率的影响。

The Effect of Sterile Acellular Dermal Matrix Use on Complication Rates in Implant-Based Immediate Breast Reconstructions.

作者信息

Lee Jun Ho, Park Youngsoo, Choi Kyoung Wook, Chung Kyu-Jin, Kim Tae Gon, Kim Yong-Ha

机构信息

Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea.

出版信息

Arch Plast Surg. 2016 Nov;43(6):523-528. doi: 10.5999/aps.2016.43.6.523. Epub 2016 Nov 18.

Abstract

BACKGROUND

The use of acellular dermal matrix (ADM) in implant-based immediate breast reconstruction has been increasing. The current ADMs available for breast reconstruction are offered as aseptic or sterile. No published studies have compared aseptic and sterile ADM in implant-based immediate breast reconstruction. The authors performed a retrospective study to evaluate the outcomes of aseptic versus sterile ADM in implant-based immediate breast reconstruction.

METHODS

Implant-based immediate breast reconstructions with ADM conducted between April 2013 and January 2016 were included. The patients were divided into 2 groups: the aseptic ADM (AlloDerm) group and the sterile ADM (MegaDerm) group. Archived records were reviewed for demographic data and postoperative complication types and frequencies. The complications included were infection, flap necrosis, capsular contracture, seroma, hematoma, and explantation for any cause.

RESULTS

Twenty patients were reconstructed with aseptic ADM, and 68 patients with sterile ADM. Rates of infection (15.0% vs. 10.3%), flap necrosis (5.0% vs. 7.4%), capsular contracture (20.0% vs. 14.7%), seroma (10.0% vs. 14.7%), hematoma (0% vs. 1.5%), and explantation (10.0% vs. 8.8%) were not significantly different in the 2 groups.

CONCLUSIONS

Sterile ADM did not provide better results regarding infectious complications than aseptic ADM in implant-based immediate breast reconstruction.

摘要

背景

脱细胞真皮基质(ADM)在基于植入物的即刻乳房重建中的应用一直在增加。目前可用于乳房重建的ADM有无菌和非无菌两种类型。尚无已发表的研究比较无菌和非无菌ADM在基于植入物的即刻乳房重建中的效果。作者进行了一项回顾性研究,以评估无菌与非无菌ADM在基于植入物的即刻乳房重建中的结果。

方法

纳入2013年4月至2016年1月期间采用ADM进行的基于植入物的即刻乳房重建病例。患者分为两组:非无菌ADM(AlloDerm)组和无菌ADM(MegaDerm)组。查阅存档记录以获取人口统计学数据以及术后并发症的类型和发生率。所包括的并发症有感染、皮瓣坏死、包膜挛缩、血清肿、血肿以及因任何原因进行的假体取出。

结果

20例患者采用非无菌ADM进行重建,68例患者采用无菌ADM进行重建。两组在感染率(15.0%对10.3%)、皮瓣坏死率(5.0%对7.4%)、包膜挛缩率(20.0%对14.7%)、血清肿发生率(10.0%对14.7%)、血肿发生率(0%对1.5%)以及假体取出率(10.0%对8.8%)方面无显著差异。

结论

在基于植入物的即刻乳房重建中,无菌ADM在感染性并发症方面并未比非无菌ADM取得更好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73b7/5122540/7ec950488152/aps-43-523-g001.jpg

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