Martins Larissa L, Barbosa Rui F, Guerreiro Frederico C, Andresen Carolina, Pereira Miguel J, Pinho Carlos J, Rebelo Marco A, Ribeiro Matilde M
Department of Plastic, Reconstructive, Craniomaxillofacial and Hand Surgery and Microsurgery Unit, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT.
Department of Plastic Surgery, Hospital da Prelada, Porto, PRT.
Cureus. 2023 Jul 4;15(7):e41343. doi: 10.7759/cureus.41343. eCollection 2023 Jul.
Implant-based submuscular breast reconstruction (SBR) can be performed with the aid of acellular dermal matrices (ADM) for implant coverage on their inferolateral pole, aiming at providing a biological interface for hiding the implant and therefore reducing the risk of complications. The purpose of this study is to assess the long-term post-operative outcomes obtained using the SBR-specific Native® ADM (DECO med s.r.l., Marcon, Venice, Italy).
All cases of Native®-assisted immediate SBR performed at our institution between October 2016 and March 2020 were retrospectively analysed. Demographic and surgical data were collected, and post-operative outcomes, including minor and major complications, were evaluated. Particular attention was paid to complications emerging before and after patient discharge. Dependence analyses were performed to uncover statistically significant relationships between risk factors and reconstructive outcomes.
Data on 100 patients were collected, for a total of 128 breasts. The mean age of the cohort was 49.5 years, the mean BMI was 23.4 kg/m2, and the mean follow-up was 24 months. Out of this, 14.1% of patients received pre-operative radiotherapy, while 16.4% underwent post-mastectomy radiotherapy. Breasts appeared to develop short-term minor complications more likely during hospitalisation (11.7% vs. 7.8%), while short-term major complications occurred more often after discharge (7.8% vs. 15.6%). The most frequent long-term complications were capsular contracture and contour defects (both 9.4%). Risk factors that showed a statistically significant relationship with complications were pre- and post-mastectomy radiotherapy and post-operative chemotherapy.
The retrospective analysis showed results in line with clinical outcomes reported in the literature for the same reconstructive technique. The use of Native® ADM in SBR is safe and effective in the long term.
基于植入物的胸大肌下乳房重建术（SBR）可借助脱细胞真皮基质（ADM）覆盖植入物的下外侧极，旨在提供一个生物界面以隐藏植入物，从而降低并发症风险。本研究的目的是评估使用特定的SBR专用Native® ADM（DECO med s.r.l.，马尔孔，威尼斯，意大利）获得的长期术后结果。
对2016年10月至2020年3月期间在本机构进行的所有采用Native®辅助即刻SBR的病例进行回顾性分析。收集人口统计学和手术数据，并评估术后结果，包括轻微和严重并发症。特别关注患者出院前后出现的并发症。进行相关性分析以揭示风险因素与重建结果之间的统计学显著关系。
收集了100例患者的数据，共涉及128个乳房。该队列的平均年龄为49.5岁，平均体重指数为23.4 kg/m²，平均随访时间为24个月。其中，14.1%的患者接受了术前放疗，而16.4%的患者接受了乳房切除术后放疗。乳房在住院期间似乎更易出现短期轻微并发症（11.7%对7.8%），而短期严重并发症在出院后更常发生（7.8%对15.6%）。最常见的长期并发症是包膜挛缩和外形缺陷（均为9.4%）。与并发症显示出统计学显著关系的风险因素是乳房切除术前和术后放疗以及术后化疗。
回顾性分析显示的结果与文献中报道的相同重建技术的临床结果一致。在SBR中使用Native® ADM从长期来看是安全有效的。
