Complication Profile of Total Submuscular Versus Prepectoral Tissue Expander Placement: A Retrospective Cohort Study.

Autor:	Soni SE; From the Department of Plastic Surgery, University of South Florida Morsani College of Medicine., Le NK; From the Department of Plastic Surgery, University of South Florida Morsani College of Medicine., Buller M; From the Department of Plastic Surgery, University of South Florida Morsani College of Medicine., Modica AD; From the Department of Plastic Surgery, University of South Florida Morsani College of Medicine., Kumar A; Department of Health Outcomes and Behavior, University of South Florida Morsani College of Medicine., Smith PD, Laronga C; Department of Women's Oncology, Breast Program, H. Lee Moffitt Cancer Center, Tampa, FL.
Jazyk:	angličtina
Zdroj:	Annals of plastic surgery [Ann Plast Surg] 2022 Jun 01; Vol. 88 (5 Suppl 5), pp. S439-S442. Date of Electronic Publication: 2022 Apr 23.
DOI:	10.1097/SAP.0000000000003165
Abstrakt:	Background: We sought to compare the safety profile of prepectoral breast reconstruction with total submuscular tissue expander reconstruction, previously our standard. Primary outcomes of interest in this retrospective cohort study were incidence of infection, hematoma, seroma, mastectomy flap necrosis, and reconstruction loss. Methods: Total submuscular and prepectoral with acellular dermal matrix reconstructions consecutively performed by a single surgeon (P.D.S.) between January 1, 2016, and December 31, 2019, were compared. Demographic and clinical characteristics, as well as complications and complication types, were extracted for all patients. A t test was used to assess differences in continuous variables. Multivariate logistics regression was used to assess the association between type of reconstruction and complication rate. The statistical significance was set at 0.05 for all comparisons. Results: A total of 133 patients (234 breasts) were included. There was a significantly greater incidence of infection (16.5% vs 5.5%, P < 0.01) in the prepectoral/acellular dermal matrix cohort. However, reconstructive loss was low in both cohorts (2.5% and 3.0%, P = 0.83). Adjusted odds ratio for complications in the prepectoral cohort was 2.26, but this was not statistically significant (adjusted P = 0.24). Conclusions: Prepectoral breast reconstruction shares an overall complication profile that is not greater than that of total submuscular reconstruction. It is associated with a greater risk of infection; however, the ability to salvage the reconstruction with early, aggressive intervention results in low rates of reconstructive loss, comparable with those of total submuscular reconstruction. Competing Interests: Conflicts of interest and sources of funding: none declared. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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