Kim Ji-Young, Jin Ung Sik
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Hanyang University Medical Center, Seoul, Republic of Korea.
Sci Rep. 2025 Apr 15;15(1):12951. doi: 10.1038/s41598-025-85973-5.
In this experimental study, we compared the outcomes between anterior-tenting and wrapping techniques in prepectoral breast reconstruction using an acellular dermal matrix (ADM). Fifteen rats were divided into control, anterior-tenting, and whole-wrapping groups, each receiving two silicone implants. In the control group, only silicone implants were placed, whereas in the anterior-tenting and whole-wrapping groups, the anterior surface of the implants and the entire implants were covered with ADM, respectively. The Animals were irradiated on one side of the back 3 weeks postoperatively and sacrificed 3 months postoperatively. The range of change in tonometry values with or without irradiation in the whole-wrapping group tended to be larger than that in the anterior-tenting group (p < 0.05). The cellular capsule was significantly thinner on the side covered by ADM (p < 0.05). There were no significant differences in other microscopic features of the cellular capsule. Microscopic analysis of the ADM revealed significant increases in thickness and collagen density with radiation exposure, whereas a significant decrease was observed in the α-smooth muscle actin-positive area, CD3-positive cell counts, and F4/80 positive area (p < 0.05). In our rat model, the whole wrapping technique led to a greater increase in intraprosthetic pressure due to radiation-related structural changes in ADM, compared to the anterior-tenting technique.
在这项实验研究中，我们比较了在使用脱细胞真皮基质（ADM）进行胸大肌前乳房重建时，前固定技术和包裹技术的效果。将15只大鼠分为对照组、前固定组和全包裹组，每组植入两个硅胶假体。对照组仅植入硅胶假体，而在前固定组和全包裹组中，假体的前表面和整个假体分别用ADM覆盖。术后3周对动物背部一侧进行照射，术后3个月处死动物。全包裹组在有或无照射情况下眼压测量值的变化范围往往比前固定组大（p < 0.05）。ADM覆盖侧的细胞包膜明显更薄（p < 0.05）。细胞包膜的其他微观特征无显著差异。对ADM的显微镜分析显示，随着辐射暴露，厚度和胶原蛋白密度显著增加，而α-平滑肌肌动蛋白阳性区域、CD3阳性细胞计数和F4/80阳性区域显著减少（p < 0.05）。在我们的大鼠模型中，与前固定技术相比，全包裹技术由于ADM的辐射相关结构变化导致假体腔内压力增加更大。
