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使用和不使用脱细胞真皮基质(ADM)的基于植入物的乳房重建的三维乳房测量比较

A 3D Mammometric Comparison of Implant-Based Breast Reconstruction With and Without Acellular Dermal Matrix (ADM).

作者信息

Tsay Cynthia, Zhu Victor, Sturrock Tracy, Shah Ajul, Kwei Stephanie

机构信息

Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, PO Box 208041, New Haven, CT, 06520-8041, USA.

出版信息

Aesthetic Plast Surg. 2018 Feb;42(1):49-58. doi: 10.1007/s00266-017-0967-z. Epub 2017 Sep 15.

Abstract

UNLABELLED

This retrospective study utilizes 3D imaging and mammometrics to compare implant-based breast reconstruction with and without the use of ADM. Previous studies have suggested improved aesthetic outcomes with the use of ADM, but none have been able to quantify this difference. Images were obtained at early and late time points following the expander-implant exchange procedure. Measurements included the point of maximum projection, the superior, inferior, medial and lateral volumetric distribution, and the distance from the point of maximum projection to the inframammary fold along the breast meridian. The patients' demographic information, implant size, and complication rate between the two cohorts were similar. In the early post-operative period, the patients with ADM demonstrated higher medial pole volume; however, this difference did not persist in the late post-operative period. Patients with ADM demonstrated a small but statistically significant greater point of maximum projection and length of lower pole curvature in comparison with the non-ADM cohort. In summary, the results of this study demonstrate improved mammometric measurements when ADM is used in implant-based breast reconstruction, supporting superior aesthetic outcomes in early and late post-operative time points.

LEVEL OF EVIDENCE III

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

未标注

这项回顾性研究利用三维成像和乳房测量学来比较使用和不使用脱细胞真皮基质(ADM)的乳房植入重建。先前的研究表明,使用ADM可改善美学效果,但尚无研究能够量化这种差异。在扩张器-植入物置换手术后的早期和晚期时间点获取图像。测量包括最大突出点、上、下、内侧和外侧体积分布,以及沿乳房子午线从最大突出点到乳房下皱襞的距离。两个队列之间患者的人口统计学信息、植入物大小和并发症发生率相似。在术后早期,使用ADM的患者内侧乳房组织体积更大;然而,这种差异在术后晚期并未持续存在。与未使用ADM的队列相比,使用ADM的患者最大突出点和下皱襞曲率长度虽小但在统计学上有显著差异。总之,本研究结果表明,在乳房植入重建中使用ADM时乳房测量结果有所改善,支持在术后早期和晚期有更好的美学效果。

证据水平III:本杂志要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南www.springer.com/00266

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