Comparison Study of Two Types of Expander-Based Breast Reconstruction
| Autor: | Kasandra R. Hanna, David B. Drake, Brent R. DeGeorge, Kant Y. Lin, Alexander F. Mericli |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Breast Implants Tissue Expansion Breast Neoplasms Postoperative Complications Patient satisfaction Surveys and Questionnaires Humans Medicine Acellular Dermis Breast Implantation Mastectomy Retrospective Studies Tissue expander business.industry Tissue Expansion Devices Middle Aged Surgery Patient Satisfaction Comparison study Female Breast reconstruction Dermal matrix business Follow-Up Studies |
| Zdroj: | Annals of Plastic Surgery. 70:10-15 |
| ISSN: | 0148-7043 |
| DOI: | 10.1097/sap.0b013e31822f6765 |
| Popis: | Recent reported complications have called some authors to express concern regarding the increased popularity of acellular dermal matrix (ADM)-based breast reconstruction, and its role as an alternative to traditional total submuscular approaches. To address this issue, we compared tissue expansion properties, complication rates, and patient satisfaction for both operative techniques at the same institution. A retrospective review was completed on 75 patients and 100 tissue expander/implant-based breast reconstructions at a single academic institution from 2007 to 2010. Of these cases, 31 patients were reconstructed with ADM and 44 with a submuscular coverage technique. Total complications including seroma, hematoma, infection, skin necrosis, and explantation did not significantly differ between groups (n = 13 for ADM vs. 17 for submuscular, P = 0.814). Consistent with prior reports, ADM-based reconstructions were associated with significantly increased intraoperative fill volumes and lower total number of sessions to achieve final volume. Submuscular reconstructions required a significantly higher tissue expander fill volume. Eight patients in the submuscular group required surgical revision of the breast and inframammary fold, compared with 4 in the ADM group; however, this difference was not significant. Patient satisfaction was equivalent between the 2 groups; however, it was higher in patients with bilateral reconstruction and lower among those who had received adjuvant radiation therapy. Satisfaction with nipple reconstruction was inversely proportional to time elapsed from the procedure to survey conduction. This is the first study to perform a head-to-head comparison on the basis of patient satisfaction, the results of which may be useful in preoperative planning and counseling. |
| Databáze: | OpenAIRE |
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