Bassetto Franco, Pandis Laura, Facchin Federico, Azzena Gian Paolo, Vindigni Vincenzo
Department of Neuroscience: Neurological, Psychiatric, Sensorial, Reconstructive, and Rehabilitative Sciences, University of Padua, Padua, Italy.
Front Surg. 2022 Nov 1;9:1009356. doi: 10.3389/fsurg.2022.1009356. eCollection 2022.
We are sitting on the cusp of the bioengineered breast era, in which implant-based breast reconstruction is seeing a growing trend and biotechnology research progressively empowers clinical practice. As never before, the choice of biomaterials has acquired great importance for achieving reconstructive outcomes, and the increase in the use of acellular dermal matrices (ADMs) in the field of senology tells us a story of profound upheaval and progress. With the advent of prepectoral breast reconstruction (PPBR), plenty of devices have been proposed to wrap the silicone prosthesis, either completely or partially. However, this has caused a great deal of confusion and dissent with regard to the adoption of feasible reconstructive strategies as well as the original scientific rationale underlying the prepectoral approach. Braxon is the very first device that made prepectoral implant positioning possible, wrapping around the prosthesis and exerting the proven ADM regenerative potential at the implant-tissue interface, taking advantage of the body's physiological healing mechanisms. To date, the Braxon method is among the most studied and practiced worldwide, and more than 50 publications confirm the superior performance of the device in the most varied clinical scenarios. However, a comprehensive record of the working of this pioneering device is still missing. Therefore, our aim with this review is to lay a structured knowledge of surgery with BRAXON and to provide a decision-making tool in the field of PPBR through a complete understanding on the very first device for prepectoral, one decade after its introduction.
我们正处于生物工程乳房时代的开端,在此时代,基于植入物的乳房重建呈增长趋势,生物技术研究也日益推动临床实践的发展。生物材料的选择对于实现重建效果前所未有的重要,乳腺学领域无细胞真皮基质(ADM)使用的增加,向我们讲述了一个深刻变革与进步的故事。随着胸肌前乳房重建(PPBR)的出现,人们提出了大量用于包裹硅胶假体的装置,或完全包裹,或部分包裹。然而,这在可行重建策略的采用以及胸肌前方法背后的原始科学原理方面引发了诸多困惑与争议。Braxon是首个使胸肌前植入物定位成为可能的装置,它环绕假体,并在植入物 - 组织界面发挥已证实的ADM再生潜力,利用人体的生理愈合机制。迄今为止,Braxon方法是全球研究和应用最多的方法之一,50多篇出版物证实了该装置在各种临床场景中的卓越性能。然而,对于这个开创性装置的工作原理仍缺乏全面记录。因此,我们撰写本综述的目的是构建关于使用BRAXON进行手术的结构化知识,并通过对引入胸肌前的首个装置进行全面了解,为PPBR领域提供一个决策工具,自其引入已过去十年。