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

IF 0.4 4区 医学 Q4 SURGERY
Kuo Chen, Jin Zhang, Narasimha M. Beeraka, Pengwei Lu
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引用次数: 0

摘要

越来越多的患者选择通过直接植入假体的乳房重建手术来进行保乳手术。传统上,这种基于假体的乳房重建手术采用的是切开胸大肌形成两个不同平面的手术方法。然而,实现令人满意的假体覆盖仍然是一个巨大的挑战,这主要是由于使用非细胞真皮基质补片会带来额外的经济负担。因此,迫切需要一种创新的手术技术来解决这一局限性。本研究的主要目的是探讨在乳房重建过程中使用胸大肌和前锯肌筋膜瓣覆盖假体的潜在优势。假体被包裹在侧组织袋中,侧组织袋由胸大肌和前锯肌筋膜制成。这项新颖的手术技术保留了胸大肌和前锯肌的原始边界,并用自体筋膜瓣替代了高成本的非细胞真皮基质。术后,所有患者的并发症发生率都有所降低,没有出现严重的术后问题。对患者进行了满意度调查,以评估重建乳房外形的美学效果。所有患者都成功完成了手术。据观察,总的并发症发生率,特别是血清肿和血肿的发生率极低,仅为 5.41%,没有发生过包膜挛缩的情况。从 BREAST-Q 问卷调查中获得的反馈信息表明,所有接受乳房再造手术的患者都对手术效果和美学效果感到满意。利用由胸大肌和前锯肌筋膜组成的皮瓣来制作包裹假体的侧组织袋,是一种可靠、安全且经济高效的手术方法。此外,这种技术还能产生美观的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Novel Strategy for Covering Implant-Based Breast Reconstruction: Pectoralis Major Fascia, Serratus Anterior Fascia, and Superficial Pectoral Fascia

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.

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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
412
审稿时长
6-12 weeks
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.
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