Kuo Chen, Jin Zhang, Narasimha M. Beeraka, Pengwei Lu
{"title":"覆盖植入物乳房重建的新策略:胸大肌筋膜、前锯肌筋膜和胸浅筋膜","authors":"Kuo Chen, Jin Zhang, Narasimha M. Beeraka, Pengwei Lu","doi":"10.1007/s12262-024-04071-4","DOIUrl":null,"url":null,"abstract":"<p>The increasing number of patients have been electing to undergo breast-conserving surgery via immediate, one-stage direct-to-implant breast reconstruction. Conventionally, this implant-based breast reconstruction is conducted utilizing a surgical methodology in which the pectoralis major muscle is incised to create two distinct planes. However, achieving satisfactory implant coverage remains a significant challenge, primarily due to the supplementary financial implications associated with the use of an acellular dermal matrix patch. There is a pressing necessity to discover an innovative surgical technique to address this limitation. The primary objective of this research is to investigate the potential advantages of employing a flap comprising the pectoralis major and serratus anterior muscle fascia for implant coverage during the process of breast reconstruction. The implant was encapsulated within a lateral tissue pocket, crafted from the fascia of the pectoralis major and serratus anterior muscles. This novel surgical technique maintained the original boundaries of the pectoralis major and serratus anterior muscles and substituted the high-cost acellular dermal matrix with an autologous fascial flap. After the operation, all patients exhibited a diminished rate of complications, with no occurrences of severe post-operative issues. Patient satisfaction surveys were administered to evaluate the esthetic effects of the reconstructed breast shape. All patients successfully underwent the surgical procedure. The aggregate complication rate, specifically for seroma and hematoma, was observed to be a minimal 5.41%, with no instances of capsular contracture recorded. Feedback obtained from the administered BREAST-Q questionnaires indicated good satisfaction and aesthetic outcomes among all the patients with reconstructed breasts. The utilization of a flap composed of the pectoralis major and serratus anterior muscle fascia to craft a lateral tissue pocket encapsulating the implant represents a reliable, secure, and economically efficient surgical methodology. Moreover, this technique can yield aesthetically pleasing outcomes.</p>","PeriodicalId":13391,"journal":{"name":"Indian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Novel Strategy for Covering Implant-Based Breast Reconstruction: Pectoralis Major Fascia, Serratus Anterior Fascia, and Superficial Pectoral Fascia\",\"authors\":\"Kuo Chen, Jin Zhang, Narasimha M. Beeraka, Pengwei Lu\",\"doi\":\"10.1007/s12262-024-04071-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>The increasing number of patients have been electing to undergo breast-conserving surgery via immediate, one-stage direct-to-implant breast reconstruction. Conventionally, this implant-based breast reconstruction is conducted utilizing a surgical methodology in which the pectoralis major muscle is incised to create two distinct planes. However, achieving satisfactory implant coverage remains a significant challenge, primarily due to the supplementary financial implications associated with the use of an acellular dermal matrix patch. There is a pressing necessity to discover an innovative surgical technique to address this limitation. The primary objective of this research is to investigate the potential advantages of employing a flap comprising the pectoralis major and serratus anterior muscle fascia for implant coverage during the process of breast reconstruction. The implant was encapsulated within a lateral tissue pocket, crafted from the fascia of the pectoralis major and serratus anterior muscles. This novel surgical technique maintained the original boundaries of the pectoralis major and serratus anterior muscles and substituted the high-cost acellular dermal matrix with an autologous fascial flap. After the operation, all patients exhibited a diminished rate of complications, with no occurrences of severe post-operative issues. Patient satisfaction surveys were administered to evaluate the esthetic effects of the reconstructed breast shape. All patients successfully underwent the surgical procedure. The aggregate complication rate, specifically for seroma and hematoma, was observed to be a minimal 5.41%, with no instances of capsular contracture recorded. Feedback obtained from the administered BREAST-Q questionnaires indicated good satisfaction and aesthetic outcomes among all the patients with reconstructed breasts. The utilization of a flap composed of the pectoralis major and serratus anterior muscle fascia to craft a lateral tissue pocket encapsulating the implant represents a reliable, secure, and economically efficient surgical methodology. Moreover, this technique can yield aesthetically pleasing outcomes.</p>\",\"PeriodicalId\":13391,\"journal\":{\"name\":\"Indian Journal of Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2024-04-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12262-024-04071-4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12262-024-04071-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
The Novel Strategy for Covering Implant-Based Breast Reconstruction: Pectoralis Major Fascia, Serratus Anterior Fascia, and Superficial Pectoral Fascia
The increasing number of patients have been electing to undergo breast-conserving surgery via immediate, one-stage direct-to-implant breast reconstruction. Conventionally, this implant-based breast reconstruction is conducted utilizing a surgical methodology in which the pectoralis major muscle is incised to create two distinct planes. However, achieving satisfactory implant coverage remains a significant challenge, primarily due to the supplementary financial implications associated with the use of an acellular dermal matrix patch. There is a pressing necessity to discover an innovative surgical technique to address this limitation. The primary objective of this research is to investigate the potential advantages of employing a flap comprising the pectoralis major and serratus anterior muscle fascia for implant coverage during the process of breast reconstruction. The implant was encapsulated within a lateral tissue pocket, crafted from the fascia of the pectoralis major and serratus anterior muscles. This novel surgical technique maintained the original boundaries of the pectoralis major and serratus anterior muscles and substituted the high-cost acellular dermal matrix with an autologous fascial flap. After the operation, all patients exhibited a diminished rate of complications, with no occurrences of severe post-operative issues. Patient satisfaction surveys were administered to evaluate the esthetic effects of the reconstructed breast shape. All patients successfully underwent the surgical procedure. The aggregate complication rate, specifically for seroma and hematoma, was observed to be a minimal 5.41%, with no instances of capsular contracture recorded. Feedback obtained from the administered BREAST-Q questionnaires indicated good satisfaction and aesthetic outcomes among all the patients with reconstructed breasts. The utilization of a flap composed of the pectoralis major and serratus anterior muscle fascia to craft a lateral tissue pocket encapsulating the implant represents a reliable, secure, and economically efficient surgical methodology. Moreover, this technique can yield aesthetically pleasing outcomes.
期刊介绍:
The Indian Journal of Surgery is the official publication of the Association of Surgeons of India that considers for publication articles in all fields of surgery. Issues are published bimonthly in the months of February, April, June, August, October and December.
The journal publishes Original article, Point of technique, Review article, Case report, Letter to editor, Teachers and surgeons from the past - A short (up to 500 words) bio sketch of a revered teacher or surgeon whom you hold in esteem and Images in surgery, surgical pathology, and surgical radiology.
A trusted resource for peer-reviewed coverage of all types of surgery
Provides a forum for surgeons in India and abroad to exchange ideas and advance the art of surgery
The official publication of the Association of Surgeons of India
92% of authors who answered a survey reported that they would definitely publish or probably publish in the journal again
The Indian Journal of Surgery offers peer-reviewed coverage of all types of surgery. The Journal publishes Original articles, Points of technique, Review articles, Case reports, Letters, Images and brief biographies of influential teachers and surgeons.
The Journal spans General Surgery, Pediatric Surgery, Neurosurgery, Plastic Surgery, Cardiothoracic Surgery, Vascular Surgery, Rural Surgery, Orthopedic Surgery, Urology, Surgical Oncology, Radiology, Anaesthesia, Trauma Services, Minimal Access Surgery, Endocrine Surgery, GI Surgery, ENT, Colorectal Surgery, surgical practice and research.
The Journal provides a forum for surgeons from India and abroad to exchange ideas, to propagate the advancement of science and the art of surgery and to promote friendship among surgeons in India and abroad. This has been a trusted platform for surgons in communicating up-to-date scientific informeation to the community.