Early Seroma Treatment Protocol Based on US-Guided Aspiration in DTI Prepectoral Reconstruction: A Prospective Study.

Autor: Cazzato V; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Scarabosio A; Department of Medical Area (DIME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy., Bottosso S; Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy., Rodda A; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Vita L; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Renzi N; Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy., Caputo G; Department of Medical Area (DIME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy., Ramella V; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Parodi PC; Department of Medical Area (DIME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy. Electronic address: piercamillo.parodi@uniud.it., Papa G; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2023 Dec; Vol. 23 (8), pp. e542-e548. Date of Electronic Publication: 2023 Sep 16.
DOI: 10.1016/j.clbc.2023.09.003
Abstrakt: Introduction: Seroma is a common complication after prepectoral prosthetic breast reconstruction with ADM, leading to wound dehiscencse, infection, and even loss of reconstruction at last. A new ultrasound (US) guided follow-up protocol has been applied to compare primary and secondary complications incidence and their treatment, and evaluate the effect of precocious seroma detection and its evacuation in reducing secondary complications.
Methods: We enrolled 406 patients from January 1st, 2021 to July 1st, 2023 who underwent mastectomy and 1-stage prepectoral reconstruction with ADM. Experimental group counted 96 patients, whom have been treated as protocol fashion, therefore with multiple US-guided evaluations and eventual evacuations along with postoperative period; control group (310 patients) has exclusively been clinically evaluated.
Results: Seroma incidence detected rate among experimental group, after 1-year follow-up, was 32.2%, compared to 16.8% in control cohort, additionally no other secondary complications were detected in the first group. Referring to the wound dehiscence incidence, a statistically significant higher frequency was observed in control group compared with treatment 1 (21.2% vs. 0%; P = .0027).
Conclusions: Seroma and correlated secondary complications may lead to additional surgeries, higher sanitary costs and even reconstructive failure. With a seriated US follow-up protocol application, the surgeon could promptly manage and treat seroma, decreasing additional complications rate, particularly wound dehiscence.
Level of Evidence: III.
Competing Interests: Disclosure The authors have stated that they have no conflicts of interest.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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