Abi-Rafeh Jad, Safran Tyler, Winocour Sebastian, Dionisopoulos Tassos, Davison Peter, Vorstenbosch Joshua
Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, QC, Canada.
Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, TX, USA.
Aesthet Surg J Open Forum. 2022 Apr 12;4:ojac025. doi: 10.1093/asjof/ojac025. eCollection 2022.
Although plastic surgeons commonly perform capsulectomies for a variety of peri-prosthetic capsular conditions, the safety of capsulectomy remains unknown, and the literature lacks evidence describing its morbidity and complication rates for patients inquiring about its associated risks.
The present study aims to identify and define the complication rates associated with capsulectomies.
An analysis of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was performed between the years 2015 and 2018. All information pertaining to demographics, patient-related information, surgical indications, procedure-related information, outcomes, and complications were assessed.
The study identified 2231 cases of surgeon-reported capsulectomies; indications most commonly reported included capsular contracture (n = 638, 28.6%) and breast implant rupture (n = 403, 18.1%). In total, 141 patients (6.32%) were hospitalized for longer than 1 postoperative day (range, 2-28 days), while the overall complication rate was 3.0% (n = 67/2231 patients). Incidence of minor complications, representing superficial surgical site infections, was 0.8%, while the major complication rate was 2.24%. These included 7 cases of deep surgical site infections (0.3%), 19 organ space infections (0.9%), and 8 cases of wound dehiscence (0.4%). Eight patients developed sepsis (0.4%); 6 patients required transfusions (0.3%); 1 case of postoperative pneumonia and 1 myocardial infarction were also identified (n = 1 each, 0.0%). The overall reoperation and readmission rates were 2.0%, representing a readmission rate of 66% among patients with complications.
The present study provides the first estimate of the incidence of complications associated with capsulectomies. Although the NSQIP database contains significant limitations, the data presented herein describe a complication profile that plastic surgeons can share with their patients during informed consent.
尽管整形外科医生通常因各种假体周围包膜情况而进行包膜切除术，但包膜切除术的安全性仍不明确，并且文献中缺乏关于其发病率以及向患者询问相关风险时并发症发生率的证据。
本研究旨在确定并界定与包膜切除术相关的并发症发生率。
对美国外科医师学会国家外科质量改进计划（NSQIP）数据库在2015年至2018年期间的数据进行分析。评估了所有与人口统计学、患者相关信息、手术指征、手术相关信息、结果及并发症有关的信息。
该研究确定了2231例外科医生报告的包膜切除术病例；最常报告的指征包括包膜挛缩（n = 638，28.6%）和乳房植入物破裂（n = 403，18.1%）。总共有141名患者（6.32%）术后住院时间超过1天（范围为2 - 28天），而总体并发症发生率为3.0%（n = 67/2231例患者）。轻微并发症（即浅表手术部位感染）的发生率为0.8%，而严重并发症发生率为2.24%。其中包括7例深部手术部位感染（0.3%）、19例器官间隙感染（0.9%）和8例伤口裂开（0.4%）。8名患者发生脓毒症（0.4%）；6名患者需要输血（0.3%）；还发现1例术后肺炎和1例心肌梗死（各1例，0.0%）。总体再次手术率和再入院率为2.0%，在有并发症的患者中，再入院率为66%。
本研究首次对与包膜切除术相关的并发症发生率进行了评估。尽管NSQIP数据库存在重大局限性，但本文所呈现的数据描述了一种并发症情况，整形外科医生在进行知情同意时可与患者分享。
