Lee Hyung-Chul, Kwon Sang-Ho, Ahn Si-Hyun, Chung Jae-Ho, Jung Seung-Pil, Yoon Eul-Sik
Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea.
Division of Breast and Endocrine Surgery, Korea University Anam Hospital, Seoul, Republic of Korea.
Gland Surg. 2025 Mar 31;14(3):317-326. doi: 10.21037/gs-2024-542. Epub 2025 Mar 26.
Red breast syndrome (RBS) is represented as idiopathic cutaneous erythema overlying the acellular dermal matrix (ADM) after implant-based breast reconstruction without other signs and symptoms of infection. Although a number of etiologies including lymphatic disruption, delayed hypersensitivity reaction to ADM, and residual DNA within ADM have been suggested for RBS, consensus regarding risk factors and treatment for RBS has been reached yet. Thus, the aim of this study was to find risk factors for RBS and introduce our experience of successful treatment of RBS.
A retrospective study was conducted for patients who underwent implant-based breast reconstruction using ADM from October 2018 to February 2021. Demographics, types of ADM used, reconstructive characteristics, and incidence of RBS were analyzed. Risk factors for RBS were investigated using the logistic regression model.
A total of 138 implant-based breast reconstructions using ADM were performed. Their average follow-up period was 17.33 months. The incidence of RBS was 5.8% (n=8) with a median onset time of 36 days. Based on the logistic regression analysis, prior history of radiotherapy [odds ratio (OR): 22.703, P=0.001] was the only significant risk factors for RBS. In most cases with RBS suspected (6 of 8), it was resolved with intravenous corticosteroid and 1 week course of oral antibiotics.
Prior history of radiotherapy was found to be significant risk factor for RBS. Single dose IV corticosteroid with 1 week course of oral antibiotics might be useful for RBS treatment.
红胸综合征（RBS）表现为在植入物乳房重建术后，无其他感染体征和症状的情况下，覆盖无细胞真皮基质（ADM）的特发性皮肤红斑。尽管对于RBS已提出了多种病因，包括淋巴系统破坏、对ADM的迟发型超敏反应以及ADM内的残留DNA，但关于RBS的危险因素和治疗方法尚未达成共识。因此，本研究的目的是找出RBS的危险因素，并介绍我们成功治疗RBS的经验。
对2018年10月至2021年2月期间使用ADM进行植入物乳房重建的患者进行回顾性研究。分析患者的人口统计学资料、所用ADM的类型、重建特征以及RBS的发生率。使用逻辑回归模型研究RBS的危险因素。
共进行了138例使用ADM的植入物乳房重建手术。平均随访期为17.33个月。RBS的发生率为5.8%（n = 8），中位发病时间为36天。基于逻辑回归分析，放疗史[比值比（OR）：22.703，P = 0.001]是RBS唯一的显著危险因素。在大多数疑似RBS的病例中（8例中的6例），通过静脉注射皮质类固醇和为期1周的口服抗生素治疗得以缓解。
放疗史被发现是RBS的显著危险因素。单剂量静脉注射皮质类固醇加为期1周的口服抗生素可能对RBS治疗有用。
