Wickman M, Jurell G
Department of Plastic and Reconstructive Surgery, Karolinska Hospital, Stockholm, Sweden.
Plast Reconstr Surg. 1997 Mar;99(3):692-7. doi: 10.1097/00006534-199703000-00014.
The expander prosthesis has the advantage over the temporary expander of being permanent and thus does not require an operation when the implant has to be exchanged for a permanent prosthesis. Forty-nine women who had had either primary or secondary breast reconstruction performed with a permanent textured expander prosthesis were included in the study. No patient in either group had received radiotherapy. Breast softness was evaluated by an objective method, applanation tonometry, when saline was extracted from the implant to the desired breast volume after 3 months of slight overexpansion. Follow-up examinations were done 6 and 12 months later. In both groups the breasts became harder between the extraction of saline and the 6-month follow-up but then remained unchanged at the 12-month checkup. The capsular contracture rate after 6 months was 11 percent in the primary breast reconstruction group (n = 37) and 0 percent in the secondary breast reconstruction group (n = 11). After 12 months, the results were constant. There was no statistically significant difference between the two groups at any time. The low capsular contracture rate in both groups shows the suitability of the expander prosthesis for achieving good results in both primary and secondary breast reconstruction. Objective evaluation of the results in order to compare different materials and methods of breast reconstruction should be mandatory.
扩张器假体相较于临时扩张器的优势在于其为永久性，因此在需将植入物更换为永久性假体时无需进行手术。本研究纳入了49例使用永久性带纹理扩张器假体进行一期或二期乳房重建的女性。两组患者均未接受过放疗。在轻微过度扩张3个月后，当从植入物中抽出盐水至期望的乳房体积时，采用客观方法即压平眼压测量法评估乳房柔软度。6个月和12个月后进行随访检查。两组乳房在抽出盐水至6个月随访期间均变硬，但在12个月检查时保持不变。一期乳房重建组（n = 37）6个月后的包膜挛缩率为11%，二期乳房重建组（n = 11）为0%。12个月后，结果保持不变。两组在任何时间均无统计学显著差异。两组较低的包膜挛缩率表明扩张器假体适用于在一期和二期乳房重建中取得良好效果。为比较不同的乳房重建材料和方法，对结果进行客观评估应成为必需。
