A Comparison of Elliptical Mastectomy to Inverted-T Pattern Mastectomy in Two-Stage Prosthetic Breast Reconstruction
| Autor: | Matthew S. Kilgo, Nadia V. Baranchuk, Jessica Korsh, Bruce W. Brewer, Barry Douglas, Allison E. Shen, Gabriel J. Kaufman |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Breast Implants Mammaplasty medicine.medical_treatment Tissue Expansion Breast Neoplasms Postoperative Complications medicine Humans Stage (cooking) Mastectomy Aged Retrospective Studies Aged 80 and over business.industry Carcinoma Ductal Breast Tissue Expansion Devices Middle Aged medicine.disease Surgery Carcinoma Lobular Treatment Outcome Seroma Female Implant Breast reconstruction Complication business Tissue expansion |
| Zdroj: | Plastic and Reconstructive Surgery. 136:426e-433e |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000001574 |
| Popis: | BACKGROUND Patients with large or ptotic breasts undergoing mastectomy followed by tissue expander/implant-based reconstruction may benefit from a Wise (inverted-T) pattern reduction mammaplasty incision compared with the traditional horizontal elliptical incision. The authors compared these two groups of patients with regard to complication rates and outcomes. METHODS Sixty-nine patients (117 breasts) were identified who underwent Wise pattern mastectomy and two-stage reconstruction. A control group of 89 patients (136 breasts) who underwent reconstruction after horizontal elliptical mastectomy were selected over the same period. Patient demographics, clinical characteristics, and complication rates were recorded and analyzed statistically. RESULTS Patient demographics (age, body mass index, diabetes, smoking, and irradiation history) and clinical characteristics (laterality, expander size and fill volume, and time to expansion) were similar, with the exception of body mass index (control, 26.7 kg/m; inverted-T, 28.7 kg/m; p = 0.04) and mean intraoperative fill volume (control, 158.7 cc; inverted-T, 196.9 cc; p = 0.02). Of all complications (infection, seroma, flap necrosis, expander loss, and salvage), only the rate of mastectomy flap necrosis was significantly greater (p = 0.002) in patients undergoing inverted-T mastectomy (25.6 percent versus 11.0 percent). This difference did not result in a significantly higher rate of expander loss or need for salvage surgery. CONCLUSIONS The inverted-T mastectomy approach can be performed safely with acceptable complication rates. When compared with an internal control group, complication rates were similar, with the exception of mastectomy flap necrosis. Despite a higher rate of flap necrosis, 91 percent of inverted-T patients successfully completed the expansion process. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III. |
| Databáze: | OpenAIRE |
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