Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan.
Medical College Aga Khan University, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan.
BMC Surg. 2024 Aug 31;24(1):245. doi: 10.1186/s12893-024-02540-x.
The incidence of breast cancer in Pakistan has been rising with approximately one third of these patients requiring mastectomy. Among breast reconstruction treatment options, the use of Acellular Dermal Matrix (ADM) for pre-pectoral breast implant surgery has proven effective with improved cosmetic outcome. However, due to high cost it cannot be regularly implemented in a developing country like Pakistan. An alternative to ADM, Polyglactin 910 (Vicryl™, Ethicon) mesh has been introduced in pre-pectoral breast reconstructive surgery which has shown to be almost 10 times lower in cost. We set out to determine the frequency of early postoperative complications when using Polyglactin 910 mesh for pre-pectoral implant-based breast reconstruction surgery.
A single centre, retrospective, chart review was conducted, and a total 28 women were included in the study. Thirty-two pre-pectoral implant-based mastectomies with Polyglactin 910 mesh were performed. Early post-operative outcomes (within 12 months of procedure) including duration of antibiotic use, post-operative infection, implant displacement, flap necrosis, seroma formation, wound dehiscence, hematoma formation, capsular contracture and reconstruction failure, were recorded.
Only 4 (12.5%) women experienced early post-operative morbidity. One patient developed a wound dehiscence, which eventually led to reconstruction failure and removal of the implant. Another patient had seroma formation and flap necrosis. None of the patients developed postoperative implant displacement, hematoma formation or capsular contracture in the early post-operative period.
This study reveals that early post-operative outcomes with Polyglactin 910 mesh in breast reconstructive surgery are few, thus making it a cost effective, reliable, and safe treatment option, especially in developing countries like Pakistan.
巴基斯坦的乳腺癌发病率一直在上升，约有三分之一的患者需要接受乳房切除术。在乳房重建治疗选择中，使用脱细胞真皮基质（ADM）进行胸肌前乳房植入手术已被证明是有效的，可改善美容效果。然而，由于成本高昂，它不能在像巴基斯坦这样的发展中国家常规实施。ADM 的替代物，聚乳酸 910（Vicryl™，Ethicon）网已被引入胸肌前乳房重建手术中，其成本低近 10 倍。我们旨在确定在使用聚乳酸 910 网进行胸肌前植入物乳房重建手术时，早期术后并发症的发生频率。
进行了一项单中心回顾性图表审查，共纳入 28 名女性进行研究。32 例胸肌前植入物乳房切除术使用聚乳酸 910 网进行。记录早期术后结果（术后 12 个月内），包括抗生素使用时间、术后感染、植入物移位、皮瓣坏死、血清肿形成、伤口裂开、血肿形成、包膜挛缩和重建失败。
只有 4 名（12.5%）女性出现早期术后并发症。1 名患者出现伤口裂开，最终导致重建失败和植入物取出。另一名患者出现血清肿形成和皮瓣坏死。在早期术后期间，没有患者出现术后植入物移位、血肿形成或包膜挛缩。
本研究表明，聚乳酸 910 网在乳房重建手术中的早期术后结果很少，因此使其成为一种具有成本效益、可靠且安全的治疗选择，特别是在像巴基斯坦这样的发展中国家。
