Akhter Haris M, Macdonald Collin, McCarthy Philip, Huang Ye, Meyer Bria R, Shostrum Valerie K, Cromer Kerry J, Johnson Perry J, Wong Shannon L, Hon Heidi H
From the Division of Plastic & Reconstructive Surgery, University of Nebraska Medical Center, College of Medicine, Omaha, Nebr.
Division of Plastic Surgery, Penn State Health, Harrisburg, Pa.
Plast Reconstr Surg Glob Open. 2023 Aug 1;11(8):e5130. doi: 10.1097/GOX.0000000000005130. eCollection 2023 Aug.
Immediate expander/implant-based breast reconstruction after mastectomy has become more sought after by patients. Although many patients choose this technique due to good aesthetic outcomes, lack of donor site morbidity, and shorter procedure times, it is not without complications. The most reported complications include seroma, infection, hematoma, mastectomy flap necrosis, wound dehiscence, and implant exposure, with an overall complication rate as high as 45%. Closed incision negative pressure therapy (ciNPT) has shown value in wound healing and reducing complications; however, the current literature is inconclusive. We aimed to examine if ciNPT improves outcomes for patients receiving this implant-based reconstruction.
This is a retrospective single-institution study evaluating the ciNPT device, 3M Prevena Restor BellaForm, on breast reconstruction patients. The study was performed between July 1, 2019 and October 30, 2020, with 125 patients (232 breasts). Seventy-seven patients (142 breasts) did not receive the ciNPT dressing, and 48 patients (90 breasts) received the ciNPT dressing. Primary outcomes were categorized by major or minor complications. Age, BMI, and final drain removal were summarized using medians and quartiles, and were compared with nonparametric Mann-Whitney test. Categorical variables were compared using chi-square or Fisher exact test.
There was a statistically significant reduction in major complications in the ciNPT group versus the standard dressing group ( = 0.0247). Drain removal time was higher in the ciNPT group.
Our study shows that ciNPT may help reduce major complication rates in implant-based breast reconstruction patients.
乳房切除术后立即采用扩张器/植入物进行乳房重建越来越受到患者的青睐。尽管许多患者因美学效果良好、供区无并发症且手术时间较短而选择这种技术，但它并非没有并发症。报道最多的并发症包括血清肿、感染、血肿、乳房切除皮瓣坏死、伤口裂开和植入物外露，总体并发症发生率高达45%。闭合切口负压疗法（ciNPT）在伤口愈合和减少并发症方面已显示出价值；然而，目前的文献尚无定论。我们旨在研究ciNPT是否能改善接受这种基于植入物重建的患者的预后。
这是一项回顾性单机构研究，评估ciNPT设备（3M Prevena Restor BellaForm）在乳房重建患者中的应用。该研究于2019年7月1日至2020年10月30日进行，共纳入125例患者（232侧乳房）。77例患者（142侧乳房）未使用ciNPT敷料，48例患者（90侧乳房）使用了ciNPT敷料。主要结局按严重或轻微并发症分类。年龄、体重指数（BMI）和最终拔除引流管情况采用中位数和四分位数进行总结，并通过非参数曼-惠特尼检验进行比较。分类变量采用卡方检验或费舍尔精确检验进行比较。
与标准敷料组相比，ciNPT组的严重并发症有统计学意义的减少（ = 0.0247）。ciNPT组的引流管拔除时间更长。
我们的研究表明，ciNPT可能有助于降低基于植入物的乳房重建患者的严重并发症发生率。
