Departement of Plastic and Reconstructive Surgery, Brugmann Center University Hospital, Université Libre de Bruxelles (ULB), Place Van Gehuchten 4, 1020 Brussels, Belgium.
Departement of Plastic and Reconstructive Surgery, Vrije Universiteit Brussels (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium.
Ann Chir Plast Esthet. 2024 Sep;69(5):400-409. doi: 10.1016/j.anplas.2024.06.010. Epub 2024 Jul 14.
Some risk factors for breast reduction complications are well known but for others the results are contradictory in scientific literature. The choice between superior pedicle and superomedial pedicle as a risk factor has been rarely studied. We aim to better identify the risk factors for breast reduction complications, including the choice between these two pedicles, in order to better prevent their occurrence.
We performed a retrospective analysis of the medical records of patients who underwent a bilateral breast reduction from august 2020 to august 2023 in our center. Patient data were obtained and correlated with postoperative complications using statistical tests and a literature search was carried out to compare our results to the current evidence.
We included 216 patients. The complication rate was 24.07%. The most frequent complication was wound dehiscence (17.59%), followed by partial Nipple-Areola-Complex necrosis or peroperative suffering requiring conversion to Nipple-Areola-Complex free graft (5.56%). Increased Body Mass Index, superomedial pedicle and resection weight ≥650g were associated with an increased probability of complication occurrence (P=0.048, P=0.005 and P=0.044). The superomedial pedicle and the resection weight ≥650g were associated with an increased probability of wound dehiscence (P=0.005 and P=0.037). The difference between the preoperative and the postoperative Sternal-Notch-Nipple distance was associated with an increased probability of partial Nipple-Areola-Complex necrosis or Nipple-Areola-Complex free graft (P=0.014).
Correcting modifiable preoperative risk factors and mastering both techniques, enabling the surgeon to choose the one best suited to each patient's clinical situation, reduces the complication rate.
一些乳房缩小并发症的风险因素是众所周知的，但对于其他因素，科学文献中的结果存在矛盾。选择上蒂还是Superomedial pedicle 作为风险因素的问题很少被研究。我们旨在更好地确定乳房缩小并发症的风险因素，包括这两种蒂的选择，以便更好地预防其发生。
我们对 2020 年 8 月至 2023 年 8 月在我们中心接受双侧乳房缩小术的患者的病历进行了回顾性分析。通过统计检验获得患者数据，并将其与术后并发症相关联，同时进行了文献检索，将我们的结果与当前证据进行比较。
我们纳入了 216 例患者。并发症发生率为 24.07%。最常见的并发症是伤口裂开（17.59%），其次是部分乳头乳晕复合体坏死或术中需要转换为乳头乳晕复合体游离皮瓣（5.56%）。增加体重指数、Superomedial pedicle 和切除重量≥650g 与并发症发生的概率增加相关（P=0.048，P=0.005 和 P=0.044）。Superomedial pedicle 和切除重量≥650g 与伤口裂开的概率增加相关（P=0.005 和 P=0.037）。术前和术后胸骨切迹乳头距离的差异与部分乳头乳晕复合体坏死或乳头乳晕复合体游离皮瓣的概率增加相关（P=0.014）。
纠正可改变的术前风险因素，并掌握这两种技术，使外科医生能够根据每个患者的临床情况选择最适合的技术，可以降低并发症的发生率。
