Griner Devan, Steffen Caleb M, Day Kristopher M, Brzezienski Mark A
From the Department of Plastic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN.
Ann Plast Surg. 2017 Dec;79(6):541-545. doi: 10.1097/SAP.0000000000001217.
Implant-based breast reconstruction is fraught with complications related to seroma formation. Soft tissue stabilization with progressive tension closure (PTC) has been shown to decrease seroma formation after various procedures but is less suitable for mastectomy flap stabilization. We evaluate the incidence of seroma in breast reconstruction using bioabsorbable barbed ribbon devices (BRDs) as a novel approach to PTC.
We performed a retrospective review of all patients whose mastectomy flaps were stabilized with BRDs. These patients were compared with consecutive patients who underwent mastectomy and reconstruction without progressive tension flap stabilization. Patient demographics and outcomes were recorded, including comorbidities, complications, presence of seroma, and total drain days.
In the BRD-PTC group, there were 36 breasts compared with 56 in the nonstabilized control group. There were no significant differences in rate of tobacco use, age, or body mass index. We identified 11 seromas in the control group (19.6%) and none in the intervention group (P = 0.05). In the PTC group, drains were removed an average of 5 days sooner than those in controls (P = 0.006).
Progressive tension stabilization of mastectomy flaps with BRD significantly reduces seroma formation and the duration for which closed suction drainage is required.
基于植入物的乳房重建充满了与血清肿形成相关的并发症。渐进性张力闭合（PTC）进行软组织稳定已被证明可减少各种手术后血清肿的形成，但不太适合乳房切除皮瓣的稳定。我们评估使用生物可吸收带刺带状装置（BRD）作为PTC的一种新方法在乳房重建中血清肿的发生率。
我们对所有使用BRD稳定乳房切除皮瓣的患者进行了回顾性研究。将这些患者与连续接受乳房切除和重建但未进行渐进性张力皮瓣稳定的患者进行比较。记录患者的人口统计学和结果，包括合并症、并发症、血清肿的存在情况以及总引流天数。
在BRD-PTC组中，有 36 个乳房，而未稳定的对照组中有 56 个。在吸烟率、年龄或体重指数方面没有显著差异。我们在对照组中发现了 11 例血清肿（19.6%），而干预组中没有（P = 0.05）。在PTC组中，引流管平均比对照组提前 5 天拔除（P = 0.006）。
使用BRD对乳房切除皮瓣进行渐进性张力稳定可显著减少血清肿的形成以及所需的闭式负压引流持续时间。
