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用于直接植入式乳房重建的SERASYNTH MESH BR的安全性和美学效果:对32例连续病例的回顾性单中心分析。

Safety and aesthetic outcomes of SERASYNTH MESH BR for direct-to-implant breast reconstruction: A retrospective single center analysis of 32 consecutive cases.

作者信息

Gruber Julia, Schlagnitweit Paul, Koulaxouzidis Georgios

机构信息

Department of Plastic, Aesthetic and Reconstructive Surgery, Sisters of Mercy Hospital Linz, Austria.

Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital Wels-Grieskirchen, Austria.

出版信息

JPRAS Open. 2023 Aug 16;38:82-90. doi: 10.1016/j.jpra.2023.08.001. eCollection 2023 Dec.

Abstract

BACKGROUND

Bilateral mastectomy for both therapeutic and prophylactic reasons is becoming increasingly important. To achieve good results after mastectomy, synthetic meshes are often used as an alternative to acellular dermal matrices (ADMs). The aim of this study is to analyze the results of subcutaneous mastectomies and direct-to-implant breast reconstruction using SERASYNTH MESH BR.

METHODS

In this work, data from mastectomies ( = 32) in 22 patients without prior radiation after breast reconstruction with SERASYNTH MESH BR from a single center were retrospectively analyzed with 1 year follow-up. Complications were categorized as serious (need for revision surgery) and minor events. Statistical analysis was performed using the -test in SPSS. Data were compared with the existing literature.

RESULTS

Major complications occurred in 15.6% ( = 5). Two out of five revisions were due to hematoma. In three cases, a seroma followed by other complications (e.g., infections, necrosis) necessitated revision. Minor complications occurred in 12.5% of cases. Due to the safety aspect, implants were replaced in each revision. There was no significant difference in complication rates between prophylactic and therapeutic mastectomies ( = 0.3815, SE = 0.171). There was no statistically significant difference in esthetic outcomes ( = 0.3846).

CONCLUSION

The application of the absorbable polymer poly-p-dioxanone SERASYNTH MESH BR has complication rates comparable to those reported in the existing literature. Careful patient selection is paramount in order to limit the complication rate. SERASYNTH MESH BR can be considered a safe tool to achieve esthetic results in combination with direct-to-implant breast reconstruction.

摘要

背景

出于治疗和预防目的的双侧乳房切除术正变得越来越重要。为了在乳房切除术后取得良好效果,合成网片常被用作脱细胞真皮基质(ADM)的替代品。本研究的目的是分析使用SERASYNTH MESH BR进行皮下乳房切除术和直接植入式乳房重建的结果。

方法

在这项研究中,回顾性分析了来自单一中心的22例患者在使用SERASYNTH MESH BR进行乳房重建后未接受过放疗的32例乳房切除术的数据,并进行了1年的随访。并发症分为严重(需要翻修手术)和轻微事件。使用SPSS中的t检验进行统计分析。数据与现有文献进行了比较。

结果

主要并发症发生率为15.6%(n = 5)。五例翻修中有两例是由于血肿。在三例中,血清肿随后出现其他并发症(如感染、坏死)需要翻修。轻微并发症发生率为12.5%。出于安全考虑,每次翻修时都更换了植入物。预防性和治疗性乳房切除术之间的并发症发生率没有显著差异(t = 0.3815,SE = 0.171)。美学效果方面没有统计学显著差异(t = 0.3846)。

结论

可吸收聚合物聚对二氧环己酮SERASYNTH MESH BR的应用并发症发生率与现有文献报道的相当。仔细选择患者对于限制并发症发生率至关重要。SERASYNTH MESH BR可被认为是与直接植入式乳房重建相结合实现美学效果的安全工具。

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