Holmes J D
Plastic Surgery and Burns Research Unit, University of Bradford.
Br J Plast Surg. 1989 Sep;42(5):591-4. doi: 10.1016/0007-1226(89)90052-0.
Tissue expansion before placement of an implant for breast reconstruction is said to lessen the chance of capsular contracture. Forty-nine patients who had undergone post-mastectomy breast reconstruction using tissue expansion were reviewed. Capsular contracture was assessed using the Baker scale and compared with the speed of expansion, the degree of over-expansion and the interval between full expansion and placement of the definitive prosthesis. The overall incidence of capsular contracture (Baker III or worse) was 29%. Only one patient, however, has required capsulotomy for capsular contracture alone. Neither the speed of expansion nor the degree of over-expansion influenced the onset of contracture. Those patients with breasts assessed in Baker group I had a significantly longer interval between full expansion and reconstruction than those in Baker group III (p = 0.05). A modification of Baker's scale is suggested for the assessment of reconstructed breasts. Prospective studies are required to define the optimum timing for tissue expansion procedures.
据说在植入物用于乳房重建之前进行组织扩张可减少包膜挛缩的几率。对49例使用组织扩张进行乳房切除术后乳房重建的患者进行了回顾性研究。使用贝克量表评估包膜挛缩情况，并与扩张速度、过度扩张程度以及完全扩张与植入最终假体之间的间隔进行比较。包膜挛缩（贝克III级或更严重）的总体发生率为29%。然而，只有一名患者仅因包膜挛缩需要进行包膜切开术。扩张速度和过度扩张程度均未影响挛缩的发生。贝克I组评估的乳房患者在完全扩张与重建之间的间隔明显长于贝克III组患者（p = 0.05）。建议对贝克量表进行修改以评估重建乳房。需要进行前瞻性研究来确定组织扩张手术的最佳时机。
