From the Department of Plastic Surgery, Asan Medical Center, University of Ulsan, School of Medicine, Seoul, Republic of Korea.
Ann Plast Surg. 2021 Nov 1;87(5):501-505. doi: 10.1097/SAP.0000000000002629.
Despite expander-based breast reconstruction being used as a reliable reconstruction method, implant removal due to wound dehiscence and infection still occurs in 0.5% to 15% of cases. This study aimed to compare the outcomes of the new inframammary fold (IMF) incision approach with previous incision in second-stage operation of expander-based 2-stage breast reconstruction.
Patients who underwent expander-based 2-stage breast reconstruction between February 2014 and May 2019 were included. After expander inflation, patients undergoing second-stage reconstruction were divided into the previous incision and IMF incision groups and their outcomes were compared. Propensity score matching analysis was performed to compare postoperative 1-year results.
The previous incision and IMF incision groups comprised 79 and 31 patients, respectively. There were no intergroup differences in general demographics or intraoperative data, except for total inflation volume (426.87 ± 102.63 mL in the previous incision group and 375.48 ± 94.10 mL in the IMF incision group, P = 0.017). Wound dehiscence occurred in 12 and 0 cases in the previous and IMF incision groups, respectively (P = 0.018). Implant removal was performed due to dehiscence in 9 cases (8.18%) and 0 cases (0%) in the previous and IMF incision groups, respectively (P = 0.049). In 1-to-1 propensity score matching analysis, the IMF incision group showed better results at 1-year follow-up (odds ratio: 0, 95% confidence interval: 0-1.09; P = 0.063).
The IMF approach is a safe method for replacing the expander with an implant, with lower incidence of wound dehiscence and implant explantation.
尽管扩张器乳房重建被用作一种可靠的重建方法，但由于伤口裂开和感染，仍有 0.5%至 15%的患者需要取出植入物。本研究旨在比较新型乳房下皱襞（IMF）切口与传统切口在扩张器-2 期乳房重建二期手术中的效果。
纳入 2014 年 2 月至 2019 年 5 月期间接受扩张器-2 期乳房重建的患者。在扩张器充气后，将接受二期重建的患者分为传统切口组和 IMF 切口组，并对其结果进行比较。采用倾向评分匹配分析比较术后 1 年的结果。
传统切口组和 IMF 切口组分别有 79 例和 31 例患者。除总充气量（传统切口组为 426.87±102.63mL，IMF 切口组为 375.48±94.10mL，P=0.017）外，两组患者一般人口统计学资料和术中数据无差异。传统切口组有 12 例（10.13%）和 IMF 切口组有 0 例（0%）发生伤口裂开（P=0.018）。由于伤口裂开，传统切口组有 9 例（8.18%）和 IMF 切口组有 0 例（0%）需要取出植入物（P=0.049）。在 1:1 倾向评分匹配分析中，IMF 切口组在 1 年随访时的结果更好（比值比：0，95%置信区间：0-1.09；P=0.063）。
IMF 入路是一种安全的方法，可以用植入物替代扩张器，伤口裂开和植入物取出的发生率较低。
