Shuck John, O'Kelly Neil, Endara Matthew, Nahabedian Maurice Y
Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA.
Alan Chen Surgical Associates, Chicago, IL, USA.
Gland Surg. 2017 Dec;6(6):659-665. doi: 10.21037/gs.2017.07.08.
Nipple preservation provides superior aesthetic results as well as patient satisfaction in patients treated with both therapeutic and prophylactic mastectomy. Post-operative nipple ischemia and necrosis presents a unique clinical challenge that may be treated with hyperbaric oxygen therapy or conservative measures alone. To date, the efficacy of hyperbaric oxygen on post-operative nipple ischemia has yet to be evaluated.
A retrospective review of patients treated with either hyperbaric oxygen or conservative management was performed. Post-operative photographs were evaluated using a novel imaging data pathway to in both groups to determine rates of healing.
Although patients treated with hyperbaric oxygen experienced rates of healing nearly twice those of patients treated with conservative measures alone, no statistical significance was found between groups in this series.
No significance difference was found between groups treated with hyperbaric oxygen or conservative management in this series. Further large scale, multi-center studies are warranted to further determine clinical utility and cost-effectiveness of hyperbaric oxygen for nipple ischemia following nipple sparing mastectomy (NSM) and implant based reconstruction.
在接受治疗性和预防性乳房切除术的患者中,保留乳头可提供更好的美学效果以及患者满意度。术后乳头缺血和坏死带来了独特的临床挑战,可通过高压氧治疗或仅采取保守措施来处理。迄今为止,高压氧对术后乳头缺血的疗效尚未得到评估。
对接受高压氧治疗或保守治疗的患者进行回顾性研究。使用一种新颖的成像数据路径对两组患者的术后照片进行评估,以确定愈合率。
尽管接受高压氧治疗的患者愈合率几乎是仅接受保守治疗患者的两倍,但在该系列研究中,两组之间未发现统计学差异。
在该系列研究中,接受高压氧治疗或保守治疗的组间未发现显著差异。有必要开展进一步的大规模、多中心研究,以进一步确定高压氧在保留乳头乳房切除术(NSM)和植入物重建术后乳头缺血治疗中的临床效用和成本效益。