Urquia Lindsey N, Hart Alexandra M, Liu Daniel Z, Losken Albert
Division of Plastic Surgery, Emory University School of Medicine, Atlanta, Ga.
Department of Surgery, Cancer Treatment Centers of America, Zion, Ill.
Plast Reconstr Surg Glob Open. 2020 Apr 23;8(4):e2744. doi: 10.1097/GOX.0000000000002744. eCollection 2020 Apr.
Prepectoral breast reconstruction has reemerged as a popular option for prosthetic-based breast reconstruction. Recent published literature highlights good outcomes; however, techniques are evolving and options exist for different technologies. The aim of this study is to evaluate short-term complication rates of prepectoral reconstructions using Cortiva acellular dermal matrix.
A multicenter retrospective study was conducted of all patients who underwent mastectomy with immediate direct-to-implant or 2-stage prepectoral breast reconstruction with Cortiva (RTI Surgical, Alachua, Fla.) between January 2016 and September 2018. The incidence of surgical complications was determined and studied against patient demographics and procedural details.
One-hundred eighteen patients met the inclusion criteria for a total of 183 individual breasts reconstructed with prepectoral implant. Average length of follow-up was 9.26 months (range, 1.0 month to 2.5 years). Thirty-two breasts (17.49%) experienced 1 or more complications. Prepectoral reconstruction was successful 89.07% of the time. Infection was the most common cause of both reoperation and implant failure, with 7.65% of all breasts requiring washout and 5.46% failing prosthetic reconstruction secondary to infection.
Surgical outcomes for prepectoral breast reconstruction using 2-stage and direct-to-implant are similar and comparable to the literature for dual-plane reconstruction, with infection being the main cause of failure.
胸前区乳房重建已再度成为基于假体的乳房重建的一种流行选择。近期发表的文献强调了良好的效果；然而，技术仍在不断发展，不同技术也存在多种选择。本研究的目的是评估使用Cortiva脱细胞真皮基质进行胸前区重建的短期并发症发生率。
对2016年1月至2018年9月期间接受乳房切除术并即刻直接植入假体或采用Cortiva（RTI Surgical，佛罗里达州阿拉楚阿）进行两阶段胸前区乳房重建的所有患者进行了一项多中心回顾性研究。确定手术并发症的发生率，并针对患者人口统计学和手术细节进行研究。
118例患者符合纳入标准，共对183个乳房进行了胸前区假体植入重建。平均随访时间为9.26个月（范围为1.0个月至2.5年）。32个乳房（17.49%）出现了1种或多种并发症。胸前区重建的成功率为89.07%。感染是再次手术和植入失败的最常见原因，所有乳房中有7.65%需要冲洗，5.46%因感染导致假体重建失败。
两阶段和直接植入式胸前区乳房重建的手术效果相似，与双平面重建的文献报道相当，感染是失败的主要原因。
