Immediate Breast Reconstruction with Prosthesis and Titanized Mesh Using a Dual-Plane Approach: Complications and Risk Factors Analysis.

Autor: Pérez-Rubio Á; Department of General and Digestive System Surgery, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain. alvaroprubio@gmail.com., Estellés Vidagany N; Department of General and Digestive System Surgery, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain., Martínez López E; Department of General and Digestive System Surgery, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain., Martínez García R; Department of General and Digestive System Surgery, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain., Sospedra Ferrer R; Department of General and Digestive System Surgery, Hospital Vithas Valencia 9 de Octubre, Valencia, Spain.
Jazyk: angličtina
Zdroj: Aesthetic plastic surgery [Aesthetic Plast Surg] 2022 Feb; Vol. 46 (1), pp. 115-122. Date of Electronic Publication: 2021 Jul 30.
DOI: 10.1007/s00266-021-02489-9
Abstrakt: Introduction: The immediate breast reconstruction after mastectomy has gained prominence in recent years and is considered one of the main procedures in oncoplastic surgery. In the case of reconstruction with prostheses, the use of a mesh to extend the pectoralis major muscle is often required to partially cover the implant. The main objective of this study was to determine the percentage of complications in immediate breast reconstructions with a titanized mesh using a dual-plane approach and establish risk factors for prosthesis complications and extrusion.
Materials and Methods: A retrospective study that included women who received postmastectomy reconstructions from January 2012 to December 2019 in a secondary hospital in Spain.
Results: A total of 57 immediate reconstructions were performed in 47 women. There were complications in 16 mastectomies (28.1%), of which seven (12.3%) were Clavien-Dindo ≤ IIIa and nine (15.7%) were IIIb. A total of three patients presented prosthetic extrusion, and the prosthesis was removed in five. The degree of contracture according to the Baker scale was I-II in 50 mastectomies (87.7%) and III-IV in seven (12.3%).
Conclusion: The immediate breast reconstruction with a titanized mesh using a dual-plane approach is a technique with an acceptable percentage of complications. The need for a Wise pattern and the necrosis of the nipple-areola complex in the postoperative period are risk factors for implant loss. Patients undergoing radiotherapy and/or chemotherapy and with a previous surgery are more likely to present capsular contracture.
Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors.
(© 2021. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)
Databáze: MEDLINE
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