Surgical Management of Breast Capsular Contracture-A Multi-institutional Data Analysis of Risk Factors for Early Complications.

Autor: Knoedler S; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Knoedler L; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Boroumand S; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Alfertshofer M; Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University, Munich, Germany., Diatta F; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Sofo G; Instituto Ivo Pitanguy, Hospital Santa Casa de Misericórdia Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Huelsboemer L; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Hansen FJ; Department of General and Visceral Surgery, Friedrich-Alexander University Erlangen, Erlangen, Germany., Könneker S; Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland., Kim BS; Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland., Perozzo FAG; Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA., Ayyala H; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Allam O; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Pomahac B; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Kauke-Navarro M; Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA. kauke-navarro.martin@yale.edu.
Jazyk: angličtina
Zdroj: Aesthetic plastic surgery [Aesthetic Plast Surg] 2024 Jun 26. Date of Electronic Publication: 2024 Jun 26.
DOI: 10.1007/s00266-024-04203-x
Abstrakt: Background: Capsular contracture (CC) is a common complication following implant-based breast surgery, often requiring surgical intervention. Yet, little is known about risk factors and outcomes following CC surgery.
Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program database (2008-2021) to identify female patients diagnosed with CC and treated surgically. Outcomes of interest included the incidence of surgical and medical complications at 30-days, reoperations, and readmissions. Confounder-adjusted multivariable analyses were performed to establish risk factors.
Results: 5,057 patients with CC were identified (mean age: 55 ± 12 years and mean body mass index [BMI]: 26 ± 6 kg/m 2 ). While 2,841 (65%) women underwent capsulectomy, capsulotomy was performed in 742 patients (15%). Implant removal and replacement were recorded in 1,160 (23%) and 315 (6.2%) cases, respectively. 319 (6.3%) patients experienced postoperative complications, with 155 (3.1%) reoperations and 99 (2.0%) readmissions. While surgical adverse events were recorded in 139 (2.7%) cases, 86 (1.7%) medical complications occurred during the 30 day follow-up. In multivariate analyses, increased BMI (OR: 1.04; p = 0.009), preoperative diagnosis of hypertension (OR: 1.48; p = 0.004), and inpatient setting (OR: 4.15; p < 0.001) were identified as risk factors of complication occurrence.
Conclusion: Based on 14 years of multi-institutional data, we calculated a net 30 day complication rate of 6.3% after the surgical treatment of CC. We identified higher BMI, hypertension, and inpatient setting as independent risk factors of postoperative complications. Plastic surgeons may wish to integrate these findings into their perioperative workflows, thus optimizing patient counseling and determining candidates' eligibility for CC surgery.
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Databáze: MEDLINE
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