Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Biomed Res Int. 2021 Jul 9;2021:3898585. doi: 10.1155/2021/3898585. eCollection 2021.
PURPOSE: Capsular formation around breast implants can produce various complications, including erythema, tenderness, discomfort, and breast deformation. Moreover, the capsule is thought to be correlated with breast implant-associated anaplastic large cell lymphoma. The proposed technique of capsule reduction can prevent some of these complications. Thus, the authors suggest a no-touch technique in two-stage, implant-based breast reconstruction. . This single-center retrospective study evaluated the medical records and digitalized pathological slides of patients who underwent two-stage, implant-based breast reconstruction between February 2018 and May 2019. The selected patients were divided into group A and group B. Group A underwent a no-touch technique that included the following two steps: (1) using a sizer as the frame to create the submuscular and acellular dermal matrix (ADM) pocket for expander insertion and (2) inserting the expander through the funnel. After the second stage of implant insertion, the capsule was harvested for biopsy of the ADM, chest wall, and muscle. RESULTS: This study included 33 breasts (31 patients): 18 in group A and 15 in group B. The capsular thicknesses of the ADM, the chest wall, and the muscle of group A were significantly thinner than those in group B. Pearson's correlation coefficient indicated negative correlations between capsular thickness and age; underlying disease; lesion side; interval of two-stage implant insertion; size of the expander; and radiotherapy, chemotherapy, or hormone therapy. CONCLUSION: To reduce the incidence of capsular formation following breast reconstruction using prostheses, a no-touch technique that uses a funnel and sizer to avoid implant contact is both efficient and beneficial.
目的:乳房植入物周围的包膜形成可导致各种并发症,包括红斑、触痛、不适和乳房变形。此外,包膜被认为与乳房植入物相关的间变性大细胞淋巴瘤有关。所提出的包膜减少技术可以预防其中一些并发症。因此,作者建议在基于假体的两阶段乳房重建中采用无接触技术。本单中心回顾性研究评估了 2018 年 2 月至 2019 年 5 月期间接受两阶段基于假体乳房重建的患者的病历和数字化病理切片。选择的患者分为 A 组和 B 组。A 组采用无接触技术,包括以下两个步骤:(1)使用扩张器作为框架,为扩张器插入创建胸肌下和无细胞真皮基质(ADM)袋;(2)通过漏斗插入扩张器。在第二阶段植入假体后,采集包膜进行 ADM、胸壁和肌肉活检。结果:本研究共纳入 33 个乳房(31 例):A 组 18 例,B 组 15 例。A 组 ADM、胸壁和肌肉的包膜厚度明显比 B 组薄。Pearson 相关系数表明,包膜厚度与年龄、基础疾病、病变侧、两阶段假体插入间隔、扩张器大小以及放疗、化疗或激素治疗呈负相关。结论:为了降低假体乳房重建后包膜形成的发生率,使用漏斗和扩张器的无接触技术可有效预防包膜形成,同时具有一定的益处。
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