人和猪细胞真皮基质在胸前乳房重建中的性能:长期临床和组织学评估。

IF 3 2区 医学 Q1 SURGERY
Allen Gabriel, G Patrick Maxwell, Erin O'Rorke, John R Harper
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引用次数: 0

摘要

背景:人类无细胞真皮基质(ADM)仍然是假体乳房重建中使用最多的基质。然而,ADMs的可获得性和成本限制了其在胸前重建中的应用--胸前重建需要大量的ADM,因此人们正在探索替代性基质:本研究旨在通过临床结果和移植物整合的组织学证据证明人-猪 ADM 构建物的安全性和有效性:方法:纳入使用人-猪 ADM 构建物进行组织扩张器/种植体重建的连续患者。在扩张器/假体交换时获取两种 ADM 的活组织切片,并对细胞化、血管化和炎症进行评估。术后并发症从患者病历中获取:结果:59 名患者符合纳入标准。平均[标准差]随访时间为6.7[0.56]年,最短随访时间为5年。并发症发生率为8.6%,包括皮肤坏死(6.9%)、血清肿(1.7%)、扩张器/植入物暴露(1.7%)和返回手术室(2.6%)。38名患者在更换扩张器/植入物时共获得了138份ADM活检标本。组织学分析表明,猪 ADM 标本与人 ADM 标本相比,成纤维细胞浸润和血管化程度较低,炎症反应较高,这与已发表的非人灵长类结果一致。尽管存在这些差异,但没有出现移植物排斥、囊膜挛缩或扩张器/假体脱落的病例:结论:猪 ADM 的临床表现与人类 ADM 相似,只是在细胞生长和血管化方面略有不同,这表明在胸大肌前乳房重建中,猪 ADM 可以替代人类 ADM:3:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Performance of Human and Porcine Derived Acellular Dermal Matrices in Prepectoral Breast Reconstruction: A Long-term Clinicaland Histologic Evaluation.

Background: Human acellular dermal matrices (ADMs) remain the most used matrices in prosthetic breast reconstruction. However, the availability and cost of ADMs limit their use in prepectoral reconstruction-which requires large amounts of ADM-and alternative matrices are therefore being explored.

Objectives: The aim of this study was to demonstrate the safety and efficacy of human-porcine ADM constructs via clinical outcomes and histologic evidence of graft integration.

Methods: Consecutive patients undergoing tissue-expander/implant reconstructions with human-porcine ADM constructs were included. Biopsies of both ADMs were obtained at expander/implant exchange and evaluated for cellularization, vascularization, and inflammation. Postoperative complications were retrieved from patient records.

Results: Fifty-nine patients met the inclusion criteria. Mean [standard deviation] follow-up was 6.7 [0.56] years; minimum follow-up was 5 years. Any complication rate was 8.6%, including skin necrosis (6.9%), seroma (1.7%), expander/implant exposure (1.7%), and return to the operating room (2.6%). A total of 138 ADM biopsy specimens were obtained from 38 patients at expander/implant exchange. Histologic analyses revealed lower fibroblast infiltration and vascularization and higher inflammatory response in porcine vs human ADM specimens, consistent with published results in nonhuman primates. Despite these differences, there were no cases of graft rejection, capsular contracture, or expander/implant loss.

Conclusions: Porcine ADM performs clinically in a similar manner to human ADM, albeit with minor differences in cellular ingrowth and vascularization, suggesting that it may be an alternative to human ADM in prepectoral breast reconstruction.

Level of evidence: 3:

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来源期刊
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.
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