Technical Refinements and Outcomes Assessment in Prepectoral Pocket Conversion After Postmastectomy Radiotherapy.

IF 3 2区医学 Q1 SURGERY

Aesthetic Surgery Journal Pub Date : 2024-05-15 DOI:10.1093/asj/sjae012

Domenico Pagliara, Corrado Rubino, Federica Grieco, Nicola Pili, Pietro Luciano Serra, Laurenza Schiavone, Melba Lattanzi, Rino Aldo Montella, Pierluigi Maria Rinaldi, Diego Ribuffo, Giorgio De Santis, Marzia Salgarello

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引用次数: 0

Abstract

Background: Several studies show how submuscular breast reconstruction is linked to animation deformity, shoulder dysfunction, and increased postoperative chest pain, when compared to prepectoral breast reconstruction. In solving all these life-impairing side effects, prepectoral implant pocket conversion has shown encouraging results.

Objectives: The aim of this study was to propose a refinement of the prepectoral implant pocket conversion applied to previously irradiated patients.

Methods: We conducted a retrospective study on 42 patients who underwent previous nipple- or skin-sparing mastectomy and immediate submuscular reconstruction, followed by radiotherapy. We performed fat grafting sessions as regenerative pretreatment. Six months after the last fat graft, we performed the conversion, with prepectoral placement of micropolyurethane foam-coated implants. We investigated the preconversion and postconversion differences in upper limb range of motion, Upper Extremity Functional Index, and patient satisfaction with the breast and physical well-being of the chest.

Results: We reported a resolution of animation deformity in 100% of cases. The range of motion and the Upper Extremity Functional Index scores were statistically improved after prepectoral implant pocket conversion. BREAST-Q scores for satisfaction with the breast and physical well-being of the chest were also improved.

Conclusions: The refined prepectoral implant pocket conversion is a reliable technique for solving animation deformity and improving quality of life in patients previously treated with submuscular reconstruction and radiotherapy.

Level of evidence: 3:

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乳房切除术后放疗中胸前凹陷转换的技术改进和效果评估

背景：多项研究表明，与胸大肌下乳房重建术相比，胸大肌下乳房重建术与动画畸形、肩关节功能障碍和术后胸痛增加有关。在解决所有这些影响生活的副作用方面，胸前假体袋转换术已取得了令人鼓舞的成果：我们的研究旨在提出一种适用于既往接受过放射治疗的患者的口前假体袋转换改进方法：方法：我们对42名既往接受过乳头或皮肤保留乳房切除术和即刻肌下重建术，随后接受放疗的患者进行了回顾性研究。我们进行了脂肪移植作为再生预处理。在最后一次脂肪移植六个月后，我们进行了胸前植入微聚氨酯泡沫涂层植入物的转换手术。我们调查了转换前和转换后在上肢活动范围、上肢功能指数、乳房满意度和身体健康胸围方面的差异：结果：100%的病例动画畸形都得到了解决。口前种植袋转换后，活动范围和上肢功能指数评分均有统计学改善。乳房满意度和身体健康胸围的 Q 值也有所提高：结论：胸廓前假体袋改良是一种可靠的技术，可以解决曾接受过肌肉下重建和放疗的患者的动画畸形问题，并改善其生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Aesthetic Surgery Journal SURGERY-

CiteScore

6.20

自引率

20.70%

发文量

309

审稿时长

6-12 weeks

期刊介绍： Aesthetic Surgery Journal is a peer-reviewed international journal focusing on scientific developments and clinical techniques in aesthetic surgery. The official publication of The Aesthetic Society, ASJ is also the official English-language journal of many major international societies of plastic, aesthetic and reconstructive surgery representing South America, Central America, Europe, Asia, and the Middle East. It is also the official journal of the British Association of Aesthetic Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery and The Rhinoplasty Society.