Breast Surgery Unit, AZIENDA USL-IRCCS Reggio Emilia, Viale Risorgimento no. 80, 42123, Reggio Emilia, Italy.
Aesthetic Plast Surg. 2020 Dec;44(6):2051-2060. doi: 10.1007/s00266-020-01651-z. Epub 2020 Feb 28.
Acellular dermal matrices have been introduced to optimize direct-to-implant breast reconstruction. We selected a bovine pericardium noncross-linked matrix.
The study consists in the retrospective analysis of 123 patients (141 breasts) who underwent conservative mastectomy and immediate implant-based breast reconstruction with bovine pericardium matrix Veritas from March 2012 to October 2017.
The overall rates of early and late complications, after a median follow-up of 51.84 months, were, respectively, 37.6% and 24.1%. The most noticeable early complications were flap ischemia [n = 39 (27.7%)], hematoma [n = 5 (3.6%)], marginal skin flap necrosis [n = 5 (3.6%)] and dehiscence of the surgical wound [n = 2 (1.4%)]. The most common late complications were rippling [n = 18 (12.7%)] and seroma [n = 4 (2.8%)]. The rate of clinically relevant capsular contracture was low: 12.1% (n = 17) presented grade II and only 2.1%% (n = 3) grade III. Implant substitution became necessary for five patients (3.6%). Early complications occurred more frequently in patients undergoing therapeutic mastectomy (p = 0.031). Patients undergoing preoperative radiotherapy more frequently developed late complications (p = 0.012). A clinically relevant capsular contracture (grade II-III) was found in higher average patients age (p = 0.0019). The left side developed less frequently late complications except for rippling (p = 0.002). Rippling occurred more frequently in patients who sustained a nipple skin-sparing mastectomy (p = 0.035).
Our results further support the safety of Veritas in immediate implant-based breast reconstruction.
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去细胞真皮基质已被引入以优化直接植入物的乳房重建。我们选择了一种牛心包非交联基质。
这项研究回顾性分析了 2012 年 3 月至 2017 年 10 月期间 123 例（141 例乳房）接受保乳切除术和即刻植入物牛心包基质 Veritas 乳房重建的患者。
中位随访 51.84 个月后，早期和晚期并发症的总发生率分别为 37.6%和 24.1%。最明显的早期并发症是皮瓣缺血[39 例（27.7%）]、血肿[5 例（3.6%）]、边缘皮瓣坏死[5 例（3.6%）]和手术切口裂开[2 例（1.4%）]。最常见的晚期并发症是波纹畸形[18 例（12.7%）]和血清肿[4 例（2.8%）]。临床上显著的包膜挛缩发生率较低：17 例（12.7%）为 2 级，仅 3 例（2.1%）为 3 级。5 例（3.6%）患者需要更换植入物。接受辅助性乳房切除术的患者早期并发症更为常见（p=0.031）。接受术前放疗的患者更常发生晚期并发症（p=0.012）。具有临床意义的包膜挛缩（2-3 级）在平均年龄较大的患者中更为常见（p=0.0019）。左侧发生晚期并发症的频率较低，但波纹畸形除外（p=0.002）。接受乳头皮肤保留乳房切除术的患者更常发生波纹畸形（p=0.035）。
我们的结果进一步支持 Veritas 在即刻植入物乳房重建中的安全性。
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