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使用无菌脱细胞真皮基质同种异体移植物的乳房重建患者的临床结果

Clinical Outcomes in Breast Reconstruction Patients Using a Sterile Acellular Dermal Matrix Allograft.

作者信息

Ortiz Juan A

机构信息

Womack Army Medical Center, Fort Bragg, NC, 28310, USA.

出版信息

Aesthetic Plast Surg. 2017 Jun;41(3):542-550. doi: 10.1007/s00266-017-0817-z. Epub 2017 Mar 9.

DOI:10.1007/s00266-017-0817-z
PMID:28280894
Abstract

BACKGROUND

Human acellular dermal matrices (ADMs) have enabled successful breast reconstructions while decreasing muscle donor morbidity and pain for the patient. However, some literature reports indicate an increase in complications, especially infection. The decellularization and terminal sterilization properties of DermACELL (D-ADM), a human ADM, may reduce the rate of complications in augmented breast reconstruction while still maintaining successful outcomes. In the study presented here, we evaluate the quality and safety of outcomes with the use of D-ADM during tissue expander breast reconstruction.

METHODS

A retrospective chart review was conducted of patients who underwent breast reconstruction with the use of D-ADM, at a single-military hospital-based practice, resulting in a population of 38 subjects and 58 breasts who had breast reconstruction augmented with D-ADM.

RESULTS

Fifty-six breasts (96.6%) in thirty-six patients demonstrated successful outcomes with a median 27 weeks' time to complete healing. Post-reconstruction radiation and chemotherapy were applied to 24.1 and 25.9% of reconstructions, respectively. Complications rates were minimal with rates of 1.7% for surgical site infection and 1.7% for red breast syndrome.

CONCLUSION

The low complication rates combined with the high success and patient satisfaction rates observed for D-ADM support the use of this ADM in breast reconstruction.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

人脱细胞真皮基质(ADM)已成功用于乳房重建,同时降低了患者肌肉供区的发病率和疼痛。然而,一些文献报道显示并发症有所增加,尤其是感染。人ADM产品DermACELL(D-ADM)的脱细胞和终端灭菌特性可能会降低隆乳重建中的并发症发生率,同时仍能保持良好的效果。在本研究中,我们评估了在组织扩张器乳房重建中使用D-ADM的效果质量和安全性。

方法

对一家军队医院的患者进行回顾性病历审查,这些患者使用D-ADM进行乳房重建,最终纳入38名受试者和58个乳房,这些乳房均采用D-ADM进行了乳房重建。

结果

36例患者中的56个乳房(96.6%)显示出成功的结果,中位愈合时间为27周。分别有24.1%和25.9%的重建接受了重建后放疗和化疗。并发症发生率极低,手术部位感染率和红乳综合征率均为1.7%。

结论

D-ADM的低并发症率以及高成功率和患者满意度支持其在乳房重建中的应用。

证据等级IV:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266 。

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