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新型内部负压系统在乳房重建中减少血清肿及其他并发症的应用

Reduction in Seroma and Other Complications with a Novel Internal Negative Pressure System in Breast Reconstruction.

作者信息

Paul Robert

机构信息

From the Ascension St. Vincent Hospital, Carmel, Ind.

出版信息

Plast Reconstr Surg Glob Open. 2023 Sep 8;11(9):e5261. doi: 10.1097/GOX.0000000000005261. eCollection 2023 Sep.

Abstract

BACKGROUND

Seroma, along with other complications, occurs as a result of poor wound healing following breast reconstructive surgery. The Interi System was developed to address the need for more effective approaches to close internal dead space and evacuate postsurgical fluid. Interi is an internal negative pressure delivery system with a unique branching manifold for broad coverage of internal tissue planes. Initial experience in a small cohort undergoing prepectoral breast reconstruction showed a clinical and statistically significant reduction in seroma and any complication versus standard drains. The purpose of this study is to report on the safety and effectiveness of Interi, compared with standard drains, in a larger patient population followed up over a longer period than our initial study.

METHODS

Data on demographics, mastectomy and reconstructive variables, postoperative complications, and manifold/drain duration were retrieved from patient records and compared between the two groups.

RESULTS

Interi was used in 100 patients (170 breasts) and standard drains in 100 patients (166 breasts). Groups were well matched in demographic, reconstructive, and mastectomy variables. Interi was removed significantly earlier than drains (16.5 versus 19.6 days; < 0.0001) and was associated with a significantly lower incidence of seroma (4.1% versus 22.9%, < 0.00001), flap revision (10.6% versus 21.7%, = 0.006), and any complication (23.5% versus 44.0%, = 0.0001).

CONCLUSIONS

Interi effectively reduced dead space and evacuated fluid from internal tissue planes, thereby decreasing seroma and other complications after prepectoral breast reconstruction. As a viable alternative to standard drains, it could significantly improve patient outcomes.

摘要

背景

血清肿与其他并发症一样,是乳房重建手术后伤口愈合不良的结果。Interi系统的开发旨在满足更有效闭合内部死腔和排出术后液体的需求。Interi是一种内部负压输送系统,具有独特的分支歧管,可广泛覆盖内部组织平面。在一小群接受胸肌前乳房重建的患者中的初步经验表明,与标准引流管相比,血清肿及任何并发症在临床和统计学上均显著减少。本研究的目的是报告与标准引流管相比,Interi在更大患者群体中、经过比我们最初研究更长时间随访后的安全性和有效性。

方法

从患者记录中检索人口统计学、乳房切除术和重建变量、术后并发症以及歧管/引流管使用时长的数据,并在两组之间进行比较。

结果

100例患者(170侧乳房)使用了Interi,100例患者(166侧乳房)使用了标准引流管。两组在人口统计学、重建和乳房切除变量方面匹配良好。Interi的拔除时间明显早于引流管(16.5天对19.6天;<0.0001),且血清肿发生率显著更低(4.1%对22.9%,<0.00001)、皮瓣修复率显著更低(10.6%对21.7%,=0.006)以及任何并发症发生率显著更低(23.5%对44.0%,=0.0001)。

结论

Interi有效减少了内部组织平面的死腔并排出了液体,从而降低了胸肌前乳房重建术后的血清肿和其他并发症。作为标准引流管的可行替代方案,它可显著改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0f9/10489512/2ef7f3f89541/gox-11-e5261-g001.jpg

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