Tyle Madison Rose, Nester Matthew, McLaughlin Mariel, Olafson Amra, Le Nicole K, Whalen Kristen, Juybari Cameron, Coughlin Emily, Mhaskar Rahul, Smith Paul D, Dayicioglu Deniz
USF Morsani College of Medicine, Tampa, Florida.
Moffitt Cancer Center, Tampa, Florida.
Eplasty. 2024 Sep 16;24:e50. eCollection 2024.
A common postoperative challenge following implant-based breast reconstruction surgery is lateral or inferior displacement of the implant, which ultimately requires surgical intervention to shape the pocket for improved symmetry. Capsulorrhaphy is traditionally performed with smooth sutures, but the use of barbed sutures has proven to be more efficient and effective in other plastic surgery procedures. This study aimed to demonstrate the safety and efficacy of barbed sutures for breast reconstruction implant capsulorrhaphy.
A retrospective cohort study was performed including all consecutive patients who underwent capsulorrhaphy by the senior author utilizing barbed sutures and, for comparison, another colleague utilizing smooth sutures from the years 2018-2021.
Twenty-eight patients were identified who underwent barbed suture capsulorrhaphy (a total of 36 breasts operated on), which was compared with 20 patients who had smooth suture capsulorrhaphy (a total of 34 breasts operated on). The average ages of the barbed and smooth suture cohorts were 55 and 53 years old ( = 1.00), respectively. The average BMI of the barbed and smooth suture cohorts were 26.7 and 25.0 kg/m ( = .15), respectively. The reoperation rates for both groups were similar at 5%. Overall complication rate was 13.9% in the barbed suture group and 8.8% in the smooth suture group, which was not statistically significant ( = .71). Patients with barbed sutures did not have an increased risk of complications compared with those who received smooth sutures (OR 1.67 (0.37-7.59), = .51).
In conclusion, performing implant-based breast reconstruction capsulorrhaphy with barbed sutures is a safe and effective procedure as compared with smooth sutures.
基于植入物的乳房重建手术后常见的一个挑战是植入物的外侧或下方移位，这最终需要进行手术干预来塑造腔隙以改善对称性。传统上，囊膜缝合术使用的是光滑缝线，但在其他整形手术中，倒刺缝线已被证明更高效且有效。本研究旨在证明倒刺缝线用于乳房重建植入物囊膜缝合术的安全性和有效性。
进行了一项回顾性队列研究，纳入了2018年至2021年期间由资深作者使用倒刺缝线进行囊膜缝合术的所有连续患者，并作为对照纳入了另一位使用光滑缝线的同事的患者。
确定了28例行倒刺缝线囊膜缝合术的患者（共对36个乳房进行了手术），并与20例行光滑缝线囊膜缝合术的患者（共对34个乳房进行了手术）进行比较。倒刺缝线组和光滑缝线组的平均年龄分别为55岁和53岁（P = 1.00）。倒刺缝线组和光滑缝线组的平均体重指数分别为26.7kg/m²和25.0kg/m²（P = 0.15）。两组的再次手术率相似，均为5%。倒刺缝线组的总体并发症发生率为13.9%，光滑缝线组为8.8%，差异无统计学意义（P = 0.71）。与接受光滑缝线的患者相比，使用倒刺缝线的患者并发症风险并未增加（比值比1.67（0.37 - 7.59），P = 0.51）。
总之，与光滑缝线相比，使用倒刺缝线进行基于植入物的乳房重建囊膜缝合术是一种安全有效的方法。
