Department of Plastic and Reconstructive Surgery, Faculty of Medicine (Boys), Al-Azhar University, Nasr City, Al Mokhaym Al Daem, Gameat Al Azhar, Cairo, Egypt.
Department of Plastic and Reconstructive Surgery, El-Sahel Teaching Hospital, Cairo, Egypt.
Aesthetic Plast Surg. 2023 Feb;47(1):130-143. doi: 10.1007/s00266-022-02901-y. Epub 2022 May 13.
Breast reconstruction can improve the quality of patients' lives by restoring the breasts' natural appearance. Saline-based tissue expanders are associated with significant drawbacks. The current systematic review and meta-analysis aimed to reveal the usability, safety, and economic burden of AeroForm-based tissue expanders for breast reconstruction.
An extensive systematic literature review was implemented from inception to 9 December 2021. All clinical studies that included women with breast cancer subjected to AeroForm-based tissue expansion for breast reconstruction were included in the study.
This systematic review included eleven articles consisting of 748 patients. There were 1220 reconstructed breasts in which 530 (43.44%) breasts were reconstructed using AeroForm devices. AeroForm-based tissue expanders were associated with shorter duration to complete breast expansion (MD-35.22; 95% -46.65, -23.78;P<0.001) and complete reconstruction (MD-30.511; 95% -54.659, -6.636;P=0.013). The overall satisfaction rate of the aesthetic results of the AeroForm expanders was 81.4% (95%CI; 60.3% to 92.6%,P=0.006) and 64.6% (95%CI; 53.8% to 74%,P=0.008) for patients and surgeons. Patients subjected to saline-based breast reconstruction were 1.17 times at high risk to develop breast-related adverse events (RR1.17; 95% 0.86, 1.58; P=0.31). This includes a high risk of mastectomy flap necrosis (RR1.91; 95% 1.03, 3.55;P=0.04) and post-operative wound infection (RR 1.63; 95% 0.91, 2.91;P=0.1).
AeroForm-based tissue expanders represent a new era of breast reconstruction. These devices provided an earlier transition to exchange for the permanent implant with a convenient and comfortable expansion process. This was associated with a high satisfaction rate for patients and surgeons.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
乳房重建可以通过恢复乳房的自然外观来提高患者的生活质量。基于盐水的组织扩张器存在显著的缺点。本系统评价和荟萃分析旨在揭示基于 AeroForm 的组织扩张器在乳房重建中的可用性、安全性和经济负担。
从成立到 2021 年 12 月 9 日,进行了广泛的系统文献检索。所有纳入接受基于 AeroForm 的组织扩张进行乳房重建的乳腺癌女性的临床研究均纳入本研究。
本系统评价包括 11 篇文章,共 748 例患者。其中 1220 个乳房进行了重建,其中 530 个(43.44%)乳房采用 AeroForm 装置进行了重建。与基于盐水的组织扩张器相比,AeroForm 基于组织扩张器的乳房扩张完成时间更短(MD-35.22;95%CI-46.65,-23.78;P<0.001)和完全重建(MD-30.511;95%CI-54.659,-6.636;P=0.013)。AeroForm 扩张器的美学效果整体满意度率为 81.4%(95%CI;60.3%至 92.6%,P=0.006)和 64.6%(95%CI;53.8%至 74%,P=0.008)为患者和外科医生。接受基于盐水的乳房重建的患者发生乳房相关不良事件的风险高 1.17 倍(RR1.17;95%CI0.86,1.58;P=0.31)。这包括乳房切除术皮瓣坏死的高风险(RR1.91;95%CI1.03,3.55;P=0.04)和术后伤口感染(RR 1.63;95%CI0.91,2.91;P=0.1)。
基于 AeroForm 的组织扩张器代表了乳房重建的新时代。这些设备为早期过渡到永久性植入物提供了便利和舒适的扩展过程,同时患者和外科医生的满意度很高。
证据水平 III:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266 。