Negenborn Vera L, Dikmans Rieky E G, Bouman Mark-Bram, Wilschut Janneke A, Mullender Margriet G, Salzberg C Andrew
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands; and Division of Plastic Surgery, Icahn School of Medicine, Mount Sinai Medical System, New York, N.Y.
Plast Reconstr Surg Glob Open. 2018 Feb 8;6(2):e1654. doi: 10.1097/GOX.0000000000001654. eCollection 2018 Feb.
Although the use of acellular dermal matrices (ADMs) in implant-based reconstruction increases, there is a lack of studies evaluating patient-reported outcome measures after this reconstruction method. We aim to evaluate the patient satisfaction after ADM-assisted implant-based breast reconstruction (IBBR) in 1 of the largest series of patients undergoing ADM-assisted IBBR.
Patients with ADM-assisted IBBR were invited to fill out the BREAST-Q, a validated and standardized questionnaire to measure patient satisfaction after a breast reconstruction. A retrospective chart review was performed to identify patient and surgical characteristics.
In total, 208 patients (38.4%) responded and reported a mean satisfaction of 70.6 ± 20.2 with their breasts and 78.0 ± 20.5 with the outcome. An overall complication rate of 7.7% was noted, with 1.5% severe complications leading to hospital readmission (0.5%) and implant removal (0.5%). Patients with complications and unilateral reconstruction for oncological reasons reported overall less satisfaction rates compared with patients with bilateral, preventive surgery, and an uncomplicated postoperative course. Strongly related domains indicate the importance of patient satisfaction with their breasts and outcome on psychosocial and sexual functioning and satisfaction with information on satisfaction with breasts, outcome, and surgeon.
There is an increased demand for patient-reported outcome measures in a changing practice to which the opinion of the patient assumes a larger role. With high satisfaction rates, ADM-assisted IBBR is a valuable reconstruction method, provided that complication rates remain low. Hence, it should only be performed in a selected group of women.
尽管在基于植入物的乳房重建中脱细胞真皮基质(ADM)的使用有所增加,但缺乏对这种重建方法后患者报告结局指标的研究。我们旨在评估接受ADM辅助的基于植入物的乳房重建(IBBR)的最大患者系列之一中的患者满意度。
邀请接受ADM辅助IBBR的患者填写BREAST-Q,这是一份经过验证的标准化问卷,用于测量乳房重建后的患者满意度。进行回顾性病历审查以确定患者和手术特征。
共有208名患者(38.4%)做出回应,报告对乳房的平均满意度为70.6±20.2,对重建结果的平均满意度为78.0±20.5。总体并发症发生率为7.7%,其中1.5%为严重并发症,导致再次入院(0.5%)和取出植入物(0.5%)。与接受双侧预防性手术且术后过程无并发症的患者相比,因肿瘤原因进行单侧重建且出现并发症的患者总体满意度较低。密切相关的领域表明患者对乳房和重建结果的满意度对心理社会和性功能以及对乳房、重建结果和外科医生满意度信息的满意度具有重要意义。
在不断变化的临床实践中,对患者报告结局指标的需求日益增加,患者的意见发挥着更大的作用。ADM辅助IBBR满意度高,是一种有价值的重建方法,前提是并发症发生率保持较低。因此,它应该只在特定的女性群体中进行。