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聚氨酯植入物完全脱细胞真皮基质包裹在即刻乳房重建术中的效果。

Outcome of complete acellular dermal matrix wrap with polyurethane implant in immediate prepectoral breast reconstruction.

作者信息

Neamonitou Foteini, Mylvaganam Senthurun, Salem Fathi, Vidya Raghavan

机构信息

Oncoplastic Breast, Department of General Surgery, The Royal of Wolverhampton NHS Trust, Wolverhampton, UK.

出版信息

Arch Plast Surg. 2020 Nov;47(6):567-573. doi: 10.5999/aps.2020.01207. Epub 2020 Nov 15.

Abstract

BACKGROUND

Polyurethane implants have been used on and off in breast reconstruction since 1991 while prepectoral breast reconstruction has gained popularity in recent times. In this study, we present our outcomes from the use of acellular dermal matrix (ADM) complete wrap with polyurethane implants in prepectoral breast reconstruction.

METHODS

This is a retrospective review of prospectively maintained database from 41 patients receiving complete ADM wrap with prepectoral polyurethane implants over a 3-year period. Selection criteria were adapted from a previous study (4135 Trust Clinical Audit Database) evaluating prepectoral reconstruction with Braxon matrices. Patient demographics, operative data, surgical complications, and outcomes were collected and analyzed.

RESULTS

A total of 52 implant reconstructions were performed in 41 patients with a mean follow-up of 14.3 months (range, 6-36 months). The overall reported complication rates including early (less than 6 weeks) and late complications. Early complications included two patients (4.9%) with wound dehiscence. One of which had an implant loss that was salvageable. Another patient (2%) developed red-breast syndrome and two women (4.9%) developed with seroma treated conservatively. Late complications included one patient (2%) with grade II capsular contraction, 12 patients with grade I-II rippling and two patients (4.9%) with grade III rippling.

CONCLUSIONS

We present our experience of prepectoral polyurethane implant using complete ADM wrap. This is one of the few papers to report on the outcome of the prepectoral use of polyurethane in immediate implant-based breast reconstruction. Our early observational series show satisfactory outcome and long-term results are warranted by a large multicenter study.

摘要

背景

自1991年以来,聚氨酯植入物在乳房重建中时断时续地被使用,而胸前置入式乳房重建近年来越来越受欢迎。在本研究中,我们展示了在胸前置入式乳房重建中使用脱细胞真皮基质(ADM)完全包裹聚氨酯植入物的结果。

方法

这是一项对前瞻性维护数据库的回顾性研究,该数据库来自41例在3年期间接受胸前置入式聚氨酯植入物并使用ADM完全包裹的患者。选择标准改编自先前一项评估使用Braxon基质进行胸前置入式重建的研究(4135信托临床审计数据库)。收集并分析了患者的人口统计学数据、手术数据、手术并发症及结果。

结果

41例患者共进行了52次植入物重建,平均随访14.3个月(范围6 - 36个月)。报告的总体并发症发生率包括早期(少于6周)和晚期并发症。早期并发症包括2例(4.9%)伤口裂开患者,其中1例发生了可挽救的植入物丢失。另1例患者(2%)出现红乳综合征,2例女性(4.9%)出现血清肿,采用保守治疗。晚期并发症包括1例(2%)II级包膜挛缩患者、12例I - II级波纹患者和2例(4.9%)III级波纹患者。

结论

我们展示了使用ADM完全包裹胸前置入式聚氨酯植入物的经验。这是少数几篇报道胸前置入式聚氨酯在即刻植入式乳房重建中结果的论文之一。我们的早期观察系列显示出令人满意的结果,大型多中心研究有必要得出长期结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76e5/7700864/601fa6107f74/aps-2020-01207f1.jpg

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