Escandón Joseph M, Nugent Ajani, Karp Nolan S, Vyas Krishna, Boyd Carter J, Kreutz-Rodrigues Lucas, Manrique Oscar J
Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St., New York, NY 11237, USA.
Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY 10016, USA.
J Pers Med. 2025 Aug 12;15(8):368. doi: 10.3390/jpm15080368.
: In the search for optimal meshes and matrices in breast surgery, poly-4-hydroxybutyrate (P4HB) has emerged as a promising alternative. This review evaluates the clinical application of P4HB scaffolds, focusing on complication rates and surgical outcomes. : A systematic search was conducted using PubMed and ScienceDirect. Clinical studies assessing perioperative outcomes and complications associated with P4HB scaffolds in breast surgery were included. Results were stratified into aesthetic and reconstructive surgery categories. Meta-analysis was implemented to assess the rate of complications and satisfaction. : This systematic review included 13 studies evaluating the use of P4HB scaffold in breast reconstruction (636 cases) and aesthetic breast surgery (462 patients). Breast reconstruction studies were all retrospective, mainly reporting two-stage, prepectoral, immediate reconstructions. Aesthetic studies included both prospective and retrospective designs, with varied implant planes and incision patterns. P4HB use was associated with high satisfaction (95.5%) and favorable outcomes, including lower odds of wound complications (log-OR = -1.135, = 0.003). Complication rates were low across both surgical categories. P4HB scaffold showed promise in supporting implant-based procedures and maintaining breast shape over time, with minimal increase in surgical time and stable anthropometric measurements. : The use of P4HB scaffold in breast reconstruction and aesthetic surgery shows promising results, notably in reducing wound-related complications. Breast reconstruction studies report low complication rates and favorable patient-reported outcomes. In aesthetic procedures, P4HB contributes to improved long-term breast shape and high satisfaction. Despite encouraging findings, further research is necessary to validate long-term efficacy and refine surgical approaches.
在寻找乳腺手术的最佳网片和基质时，聚-4-羟基丁酸酯（P4HB）已成为一种有前景的替代品。本综述评估了P4HB支架的临床应用，重点关注并发症发生率和手术效果。：使用PubMed和ScienceDirect进行了系统检索。纳入了评估乳腺手术中与P4HB支架相关的围手术期结果和并发症的临床研究。结果分为美容手术和重建手术类别。进行荟萃分析以评估并发症发生率和满意度。：本系统综述包括13项评估P4HB支架在乳房重建（636例）和美容乳腺手术（462例患者）中应用的研究。乳房重建研究均为回顾性研究，主要报告两阶段、胸肌前、即刻重建。美容研究包括前瞻性和回顾性设计，植入平面和切口模式各不相同。使用P4HB与高满意度（95.5%）和良好结果相关，包括伤口并发症几率较低（对数比值比=-1.135，P=0.003）。两个手术类别的并发症发生率均较低。P4HB支架在支持基于植入物的手术和长期维持乳房形状方面显示出前景，手术时间增加 minimal，人体测量稳定。：P4HB支架在乳房重建和美容手术中的应用显示出有前景的结果，尤其是在减少与伤口相关的并发症方面。乳房重建研究报告的并发症发生率较低，患者报告的结果良好。在美容手术中，P4HB有助于改善长期乳房形状并提高满意度。尽管有令人鼓舞的发现，但仍需要进一步研究来验证长期疗效并完善手术方法。
