General Surgery Department, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Road, Yongchuan District, Chongqing, 402160, China.
Department of Surgery, Maternal and Child Health Hospital of Yongchuan, Chongqing, 402160, China.
Aesthetic Plast Surg. 2024 Mar;48(5):925-935. doi: 10.1007/s00266-023-03500-1. Epub 2023 Jul 18.
BACKGROUND: Implant-based breast reconstruction (IBBR) can be performed using a variety of biological and synthetic meshes. However, there has yet to be a consensus on the optimal mesh. This study investigates the safety and patient satisfaction of using TiLOOP® Bra in IBBR and compares its postoperative complication risk with that of porcine acellular dermal matrix (ADM) and SERAGYN® BR. METHODS: The literature review was performed via PRISMA criteria, 23 studies met the inclusion criteria for the TiLOOP® Bra review, and 5 studies met the inclusion criteria for the meta-analysis. Patient characteristics and per-breast complications were collected. Data were analyzed using Cochrane RevMan and IBM SPSS. RESULTS: In 3175 breasts of 2685 patients that underwent IBBR using TiLOOP® Bra, rippling was observed as the most common complication, followed by seroma and capsular contracture. No significant difference in the overall complication rate between pre- and sub-pectoral IBBR using TiLOOP® Bra. However, the meta-analysis showed that the TiLOOP® Bra group had significantly lower odds of implant loss, seroma, wound dehiscence, and the need for reoperation or hospitalization than the ADM group. Additionally, the TiLOOP® Bra group had a significantly lower seroma rate compared to the SERAGYN® BR group, while the other outcome indicators were similar between the two groups. CONCLUSION: TiLOOP® Bra has become increasingly popular in IBBR in recent years. This review and meta-analysis support the favorable safety profile of TiLOOP® Bra reported in the current literature. The meta-analysis revealed that TiLOOP® Bra has better safety than ADM and a comparable risk of complications compared to SERAGYN® BR. However, as most studies had low levels of evidence, further investigations are necessary. LEVEL OF EVIDENCE III: 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 .
背景：基于植入物的乳房重建（IBBR）可以使用各种生物和合成网进行。然而，对于最佳网片仍未达成共识。本研究旨在探讨 TiLOOP®Bra 在 IBBR 中的安全性和患者满意度，并将其术后并发症风险与猪去细胞真皮基质（ADM）和 SERAGYN®BR 进行比较。
方法：文献综述采用 PRISMA 标准进行，23 项研究符合 TiLOOP®Bra 综述的纳入标准，5 项研究符合荟萃分析的纳入标准。收集患者特征和每侧乳房的并发症。使用 Cochrane RevMan 和 IBM SPSS 分析数据。
结果：在 2685 例接受 TiLOOP®Bra 行 IBBR 的 3175 侧乳房中，最常见的并发症是波纹，其次是血清肿和包膜挛缩。TiLOOP®Bra 用于胸肌前和胸肌下 IBBR 的总并发症发生率无显著差异。然而，荟萃分析显示，TiLOOP®Bra 组在乳房植入物丢失、血清肿、伤口裂开以及需要再次手术或住院治疗的可能性方面，明显低于 ADM 组。此外，与 SERAGYN®BR 组相比，TiLOOP®Bra 组的血清肿发生率明显较低，而两组的其他结局指标相似。
结论：近年来，TiLOOP®Bra 在 IBBR 中越来越受欢迎。本综述和荟萃分析支持当前文献中报道的 TiLOOP®Bra 的良好安全性。荟萃分析显示，TiLOOP®Bra 的安全性优于 ADM，与 SERAGYN®BR 的并发症风险相当。然而，由于大多数研究的证据水平较低，需要进一步研究。
证据水平 III：本杂志要求作者为每篇文章分配一个证据级别。有关这些循证医学评级的完整描述，请参阅目录或在线向作者说明 www.springer.com/00266 。
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