J. Aguilera-Sáez, P. Bosacoma Roura, Anselmo Garrido Ferrer, A. Guinot Madridejos, J. Barret
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The total rate of complications was 41.67% (35 patients): we found 11 cases of erythema (13.1%), 19 cases of seroma (22.62%), 9 cases of hematoma (10.71%), 17 cases of wound dehiscence (20.24%), 11 cases of skin flap necrosis (13.1%), and 10 cases of reconstruction failure (11.9%). The probability of reconstruction failure was higher in smokers and former smokers (P=0.0011%). There were more complications with the Protexa matrix than with the other 2, Strattice and Tutomesh (P<0.001) and a higher risk of reconstruction failure as well (P=0.03). Conclusions: In our experience the use of acellular matrix in IBIBR can have a high rate of complications, especially during the learning curve. Therefore, the selection of suitable patients and the better matrix is an issue of great importance to achieve favorable results.","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"1 1","pages":"e52"},"PeriodicalIF":0.3000,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Early complications in cases series in implant-based immediate breast reconstruction with a biological acellular matrix during the learning curve of this technique and using 3 different matrices: a case series of 84 breasts\",\"authors\":\"J. Aguilera-Sáez, P. Bosacoma Roura, Anselmo Garrido Ferrer, A. Guinot Madridejos, J. Barret\",\"doi\":\"10.1097/IJ9.0000000000000052\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: We present our experience in implant-based immediate breast reconstruction (IBIBR) with biological acellular matrix during our learning curve and compare the complications with the use of three different matrices. Materials and methods: We did a retrospective study on patients who underwent an IBIBR with acellular matrix after skin sparing mastectomy with or without nipple-areolar complex preservation at the Breast Pathology Unit at University Hospital Vall d’Hebron, Barcelona (Spain) between July 2011 and December 2014. Results: A total of 84 breasts were reconstructed in 71 women. A therapeutic mastectomy was performed in 55 of them (65.5%) and a prophylactic mastectomy in 29 (34.5%). The total rate of complications was 41.67% (35 patients): we found 11 cases of erythema (13.1%), 19 cases of seroma (22.62%), 9 cases of hematoma (10.71%), 17 cases of wound dehiscence (20.24%), 11 cases of skin flap necrosis (13.1%), and 10 cases of reconstruction failure (11.9%). The probability of reconstruction failure was higher in smokers and former smokers (P=0.0011%). There were more complications with the Protexa matrix than with the other 2, Strattice and Tutomesh (P<0.001) and a higher risk of reconstruction failure as well (P=0.03). Conclusions: In our experience the use of acellular matrix in IBIBR can have a high rate of complications, especially during the learning curve. 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引用次数: 3
摘要
简介:在我们的学习曲线中,我们介绍了使用生物脱细胞基质进行植入式即刻乳房重建(IBIBR)的经验,并比较了使用三种不同基质的并发症。材料和方法:我们对2011年7月至2014年12月在西班牙巴塞罗那Vall d 'Hebron大学医院乳腺病理科进行的保留皮肤乳房切除术(有或没有保留乳头-乳晕复体)后行脱细胞基质IBIBR的患者进行了回顾性研究。结果:71例患者共行84个乳房再造术。其中治疗性乳房切除术55例(65.5%),预防性乳房切除术29例(34.5%)。并发症发生率为41.67%(35例),其中红斑11例(13.1%),血肿19例(22.62%),血肿9例(10.71%),创面裂开17例(20.24%),皮瓣坏死11例(13.1%),重建失败10例(11.9%)。吸烟者和已戒烟者重建失败的概率较高(P=0.0011%)。与Strattice和Tutomesh相比,Protexa基质的并发症更多(P<0.001),重建失败的风险也更高(P=0.03)。结论:根据我们的经验,在IBIBR中使用脱细胞基质可能有很高的并发症发生率,特别是在学习曲线期间。因此,选择合适的患者和更好的基质是一个非常重要的问题,以取得良好的效果。
Early complications in cases series in implant-based immediate breast reconstruction with a biological acellular matrix during the learning curve of this technique and using 3 different matrices: a case series of 84 breasts
Introduction: We present our experience in implant-based immediate breast reconstruction (IBIBR) with biological acellular matrix during our learning curve and compare the complications with the use of three different matrices. Materials and methods: We did a retrospective study on patients who underwent an IBIBR with acellular matrix after skin sparing mastectomy with or without nipple-areolar complex preservation at the Breast Pathology Unit at University Hospital Vall d’Hebron, Barcelona (Spain) between July 2011 and December 2014. Results: A total of 84 breasts were reconstructed in 71 women. A therapeutic mastectomy was performed in 55 of them (65.5%) and a prophylactic mastectomy in 29 (34.5%). The total rate of complications was 41.67% (35 patients): we found 11 cases of erythema (13.1%), 19 cases of seroma (22.62%), 9 cases of hematoma (10.71%), 17 cases of wound dehiscence (20.24%), 11 cases of skin flap necrosis (13.1%), and 10 cases of reconstruction failure (11.9%). The probability of reconstruction failure was higher in smokers and former smokers (P=0.0011%). There were more complications with the Protexa matrix than with the other 2, Strattice and Tutomesh (P<0.001) and a higher risk of reconstruction failure as well (P=0.03). Conclusions: In our experience the use of acellular matrix in IBIBR can have a high rate of complications, especially during the learning curve. Therefore, the selection of suitable patients and the better matrix is an issue of great importance to achieve favorable results.