From 0 to 100: Delayed Direct to Implant Breast Reconstruction, an Alternative to Tissue Expansion.

IF 1.6 4区医学 Q3 SURGERY

Annals of Plastic Surgery Pub Date : 2025-06-01 DOI:10.1097/SAP.0000000000004384

Nicole K Le, Kristen Whalen, Amra Olafson, Brandon Foley, Allison Miscik, Eric Clayman, Pietro Susini, Nicholas J Panetta, Lauren Kuykendall, Deniz Dayicioglu, Paul D Smith

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引用次数: 0

Abstract

Introduction: Implant-based reconstruction is not always feasible when mastectomy flap viability is poor. Rather than returning to the operating room for staged breast reconstruction with tissue expansion (TE), patients may instead opt for delayed direct to implant (dDTI) reconstruction. This study aimed to assess the feasibility of dDTI after patients "go flat" after their mastectomy.

Methods: Patients unable to undergo breast reconstruction at the time of their mastectomy and who later underwent implant placement without tissue expanders between 2022 and 2024 were included in this study. These patients were compared with patients who underwent delayed tissue expander to implant-based reconstruction.

Results: A total of 36 patients (64 breasts) were included in the study (31 TE and 33 dDTI breasts). The average age was 52 ± 13 years, and average body mass index was 26.3 ± 4.8 kg/m2. The mean time between mastectomy and dDTI was 278.9 ± 180.2 days. dDTI had fewer complications than TE (3.0% vs 35.5%, P < 0.01). Univariate logistic regression showed that patients with dDTI had significantly lower odds of having complications compared with TE (odds ratio, 0.06 [0.01-1.22]; P < 0.01).

Conclusions: dDTIs appear to be a safe alternative to TE, especially when implant-based reconstruction is not feasible. This technique saves the patient, at minimum, an additional surgery and multiple clinic visits that would have been required if tissue expanders were used.

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从0到100：延迟直接植入乳房重建，替代组织扩张。

摘要：乳房切除术皮瓣生存能力差时，植体重建并不总是可行的。而不是返回手术室分阶段乳房重建与组织扩张（TE），患者可能会选择延迟直接植入（dDTI）重建。本研究旨在评估乳腺切除术后患者“平坦”后dDTI的可行性。方法：在2022年至2024年期间，在乳房切除术时无法进行乳房重建且随后在没有组织扩张器的情况下进行植入的患者纳入本研究。将这些患者与接受延迟组织扩张器和植体重建的患者进行比较。结果：共纳入36例患者（64个乳房），其中TE 31个，dDTI 33个。平均年龄52±13岁，平均体重指数26.3±4.8 kg/m2。从乳房切除术到dDTI的平均时间为278.9±180.2天。dDTI并发症发生率低于TE （3.0% vs 35.5%, P < 0.01）。单因素logistic回归显示，与TE相比，dDTI患者发生并发症的几率显著降低(优势比为0.06 [0.01-1.22]；P < 0.01)。结论：dDTIs似乎是TE的安全替代品，特别是当基于种植体的重建不可行的情况下。如果使用组织扩张器，这项技术至少可以节省患者额外的手术和多次诊所就诊。

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

Annals of Plastic Surgery 医学-外科

CiteScore

2.70

自引率

13.30%

发文量

584

审稿时长

6 months

期刊介绍： The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.