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Eroglu S, Buyukdogan H, Duran A. Direct-to-Implant Retropectoral Dual Plane Approach With Autologous Inferior-Based Dermal Flap: Does SPY-Elite Laser Angiographic System Reduce Complication Rates? Aesthetic Plast Surg 2024:10.1007/s00266-024-04075-1. [PMID: 38698224 DOI: 10.1007/s00266-024-04075-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/09/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE The study aims to investigate the complications and long-term outcomes associated with retropectoral DTI breast reconstruction with IDF utilizing the SPY-Elite laser angiographic system. MATERIAL AND METHOD This retrospective study was conducted from June 2017 to January 2023. We examined 52 patients (85 breasts) treated with a direct-to-implant retropectoral dual plane approach with IDF implant coverage. Informed consent was duly obtained from every participant. Inclusion criteria dictated that patients should have medium to large breasts and a second or third degree of ptosis, as per the Regnault ptosis scale. During the intraoperative evaluation, the mastectomy flaps and IDF were assessed with the SPY-Elite laser angiographic system using near-infrared imaging. We recorded patient demographics, characteristic data, and complications. RESULTS A total of 52 patients, aged 27 to 63, underwent 85 mastectomies using a direct-to-implant retropectoral approach with inferior dermal flap. The average age of the patients was 48, and their average body mass index was 30.8, with a range of 28 to 43. The distance from the nipple to the inframammary fold varied between 14 and 24 cm. The implants used had an average size of 275 cc, ranging from 250 to 650 cc. Textured anatomic implants with either moderate plus or high profile were used in all cases. The sternal notch to nipple distance for these patients ranged from 24 to 38 cm. During the evaluation using the SPY-Elite laser angiographic system, insufficient distal marginal perfusion was detected in five out of 85 inferior dermal flaps, measuring between 2 and 5 cm2. These areas were subsequently debrided, and the reconstructions were successfully completed, representing 5.8% of cases. No instances of necrosis related to IDF have been observed. There have been no failed assessments conducted by SPY ICG. In total, the complication rate was 15.2%, with minor complications occurring in 8.2% of the breasts (7 out of 85) and major ones in 7% (6 out of 85). The subjects were monitored for an average of 14 months, the duration ranging from 12 to 24 months. CONCLUSION Inferior dermal flaps have considerable advantages, such as a natural autologous blood supply, a more realistic tissue thickness and texture, lower costs, and better tolerance to post-reconstruction radiation. Moreover, using the IDF technique and assessing the perfusion of IDF and mastectomy flaps through the SPY-Elite laser angiographic system appears to be a dependable, efficient way to achieve good cosmetic results in one operation, eliminating the need for additional surgeries. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Sinem Eroglu
- Department of Plastic, Reconstructive and Aesthetic Surgery, Altinbas University, Istanbul, Turkey
| | - Hasan Buyukdogan
- Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey
| | - Alpay Duran
- Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey.
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Yoo BW, Kong YT, Chae SW, Kim KN, Song B, Kim J. Comparison of the Characteristics of Three Acellular Dermal Matrices Subjected to Distinct Processing Methods Using Five Types of Histochemical Staining. Aesthetic Plast Surg 2023:10.1007/s00266-023-03318-x. [PMID: 37130991 DOI: 10.1007/s00266-023-03318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/04/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Acellular dermal matrix (ADM) is treated using various devitalization and aseptic processing methods. The processing effects on ADM were evaluated by histochemical tests. METHODS From January 2014 to December 2016, 18 patients [average age, 43.0 (range, 30-54) years] who underwent breast reconstruction with an ADM and tissue expander were prospectively enrolled. During the permanent implant replacement, a biopsy of the ADM was performed. We used three different human-derived products, namely, Alloderm®, Allomend®, and Megaderm®. Hematoxylin and eosin, CD68, CD3, CD31, and smooth muscle actin were used to evaluate the collagen structure, inflammation, angiogenesis, and myofibroblast infiltration. Each ADM was semi-quantitatively analyzed. RESULTS Significant differences in collagen degradation, acute inflammation, and myofibroblast infiltration were observed among the ADMs. Collagen degeneration (p<0.001) and myofibroblast infiltration (smooth muscle actin-positive, p=0.018; CD31-negative, p=0.765) were the most severe in Megaderm®. Acute inflammation, represented by CD68, was most severe in Alloderm® (p=0.024). Both radiation and freeze-drying treatment physically damaged the collagen structure. Collagen degeneration was most severe in Megaderm®, followed by Allomend® and Alloderm®. Since Alloderm® is treated using chemicals, an assessment of the chemical irritation is warranted. CONCLUSIONS The biopsy results were inconclusive. Therefore, to better interpret processing, more large-scale, serial, histochemical studies of each ADM are needed. LEVEL OF EVIDENCE IV This journal requires that authors 38 assign a level of evidence to each article. For a full 39 description of these Evidence-Based Medicine ratings, 40 please refer to the Table of Contents or the online 41 Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Byung Woo Yoo
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yu Taek Kong
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seoung Wan Chae
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyu Nam Kim
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Boram Song
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Junekyu Kim
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Bushong EE, Komorowska-Timek ED, Parker J. Correction of Breast Ptosis in Immediate Breast Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5000. [PMID: 37235135 PMCID: PMC10208701 DOI: 10.1097/gox.0000000000005000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/22/2023] [Indexed: 05/28/2023]
Abstract
Nipple-sparing mastectomy is psychologically advantageous and can result in superior cosmetic outcomes. However, nipple position adjustment is challenging, and ischemic complications may arise. For patients who require timely mastectomies and reconstructions, concurrent mastopexy may prevent nipple malposition and reduce the risk for future corrections. Methods A retrospective chart review of all patients undergoing immediate prosthetic reconstruction after nipple-sparing mastectomy were analyzed. Data regarding patient characteristics; surgical indications; reconstructive modality, including presence or absence of simultaneous nipple lift; and early and late complications were examined. Results In total, 142 patients underwent 228 nipple-sparing mastectomies and prosthetic reconstructions. Correction of ptosis (lift) was performed in 22 patients and 34 breasts. The remaining 122 patients and 194 breasts did not receive mastopexy (no-lift). Two patients received bilateral reconstructions involving both lift and no-lift. Comparing the lift and no-lift cohorts demonstrated no differences in major complications (47.1% versus 57.7%; P = 0.25) and minor complications (76.5% versus 74.7%; P = 0.83). Control for plane of implant placement also did not show differences in major (P = 0.31) or minor (P = 0.97) complications. Similarly, control of application of acellular dermal matrix found major (P = 0.25) and minor (P = 0.83) complications uniform and not affected by lift status. Nipple lift distance was not associated with increased major (P = 0.10) complications. Conclusion Simultaneous correction of nipple position in immediate prosthetic breast reconstruction seem safe with uniform complications rates that are unaffected by acellular dermal matrix use or plane of implant placement.
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Affiliation(s)
- Elizabeth E. Bushong
- From the Michigan State University College of Human Medicine, Grand Rapids, Mich
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A Comparative Study of Secondary Procedures after Subpectoral and Prepectoral Single-Stage Implant-Based Breast Reconstruction. Plast Reconstr Surg 2023; 151:7-15. [PMID: 36194056 DOI: 10.1097/prs.0000000000009745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Implant-based breast reconstruction (IBR) is the most commonly used procedure to reconstruct the breast after mastectomy. The advantages and disadvantages of subpectoral versus prepectoral implant placement remain a matter of debate. This study compares the need for secondary aesthetic procedures between prepectoral and subpectoral IBR. METHODS This is a retrospective cohort study of consecutive patients who underwent subpectoral or prepectoral IBR between 2015 and 2018 under a single surgeon at a tertiary breast unit. The primary endpoint was the number of secondary procedures performed to improve the aesthetic outcome. Secondary endpoints included the number of secondary procedures during the first year. RESULTS A total of 271 one-stage IBRs were performed (subpectoral, n = 128 in 74 patients; prepectoral, n = 143 in 84 patients). Overall, more patients required secondary procedures in the subpectoral group (36.5% versus 19%; P = 0.014), although through longer follow-up. The most common procedures were pocket revision and implant exchange [11.7% versus 3.5% ( P = 0.010); 11.7% versus 4.2% ( P = 0.021)], whereas fat grafting was similar between the two groups (46% versus 40.5%; P = 0.777). When adjusted for follow-up time, there was no significant difference in the number of secondary procedures undertaken in the subpectoral versus the prepectoral group (21% versus 16%, respectively; P = 0.288) at 1 year. CONCLUSIONS The requirement for secondary procedures at 1 year was not different between groups. The need for fat grafting was not increased following prepectoral IBR. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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Mata Ribeiro L, Meireles RP, Brito IM, Costa PM, Rebelo MA, Barbosa RF, Choupina MP, Pinho CJ, Ribeiro MP. Comparison of Outcomes in Immediate Implant-Based Breast Reconstruction: Acellular Dermal Matrix versus Inferior Dermal Flap. Arch Plast Surg 2022; 49:158-165. [PMID: 35832670 PMCID: PMC9045524 DOI: 10.1055/s-0042-1744404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
Implant-based breast reconstruction has evolved tremendously in the last decades, mainly due to the development of new products and techniques that make the procedure safer and more reliable. The purpose of this study was to compare the outcomes in immediate one-stage breast reconstruction between acellular dermal matrix (ADM) and inferior dermal flap (IDF).
Methods
We conducted a retrospective comparative study of patients submitted to immediate breast reconstructions with an anatomical implant and ADM or IDF in a single center between 2016 and 2018. Outcomes evaluated included major complications, early complications, reinterventions, readmissions, and reconstruction failure. Simple descriptive statistics and univariate analysis were performed.
Results
A total of 118 breast reconstructions (85 patients) were included in the analysis. Patients in the IDF group had a higher body mass index (median = 27.0) than patients in the ADM group (median = 24). There were no statistically significant differences among both groups regarding immediate major complication, early complications, readmissions, and reinterventions.
Conclusion
There are no significant differences in complications between the ADM and IDF approach to immediate implant breast reconstruction. In patients with higher body mass index and large, ptotic breasts, we recommend an immediate implant reconstruction with IDF.
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Affiliation(s)
- Luís Mata Ribeiro
- Plastic and Reconstructive Surgery Department, Centro Hospitalar Universitário Lisboa Central, Hospital São José, Lisbon, Portugal
| | - Rita P. Meireles
- Plastic and Reconstructive Surgery Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Irís M. Brito
- Plastic and Reconstructive Surgery Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Patrícia M. Costa
- Plastic and Reconstructive Surgery Department, Centro Hospitalar Universitário Lisboa Central, Hospital São José, Lisbon, Portugal
| | - Marco A. Rebelo
- Plastic and Reconstructive Surgery Department, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Rui F. Barbosa
- Plastic and Reconstructive Surgery Department, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Miguel P. Choupina
- Plastic and Reconstructive Surgery Department, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Carlos J. Pinho
- Plastic and Reconstructive Surgery Department, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Matilde P. Ribeiro
- Plastic and Reconstructive Surgery Department, Instituto Português de Oncologia do Porto, Porto, Portugal
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Ribeiro LM, Meireles RP, Brito IM, Costa PM, Rebelo MA, Barbosa RF, Choupina MP, Pinho CJ, Ribeiro MP. Impact of Body Mass Index, Age and Tobacco Use on the Outcomes of Immediate Breast Reconstruction with Implants and Acellular Dermal Matrix. Indian J Plast Surg 2021; 54:350-357. [PMID: 34667523 PMCID: PMC8515419 DOI: 10.1055/s-0041-1735422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background This study aimed to analyze the effect of body mass index (BMI), age, and tobacco use on alloplastic breast reconstruction. Methods We conducted a retrospective study of patients who submitted to immediate breast reconstructions with an anatomical implant and acellular dermal matrix in a single center between 2016 and 2018. Outcomes evaluated included immediate complications, early complications, reinterventions, readmissions, and reconstruction failure. Patients were divided into two groups concerning each potential risk factor (BMI < or ≥25; age < or ≥ 50 years; and smokers vs nonsmokers). Simple descriptive statistics and univariate analysis were performed. Results A total of 101 breast reconstructions (73 patients) were included in the analysis. The mean BMI was 24, and the mean age was 44.5 years old. Smokers accounted for 14 breast reconstructions (13.9%). The rate of early infections, mastectomy flap necrosis, and implant removal was significantly higher in overweight patients. The total volume of breast drainage was higher in the age ≥ 50 years group. Smoking did not alter the outcomes. Conclusions A BMI ≥ 25 is a risk factor for early infections and reconstructive failure. Age ≥ 50 years is associated with a higher volume of breast drainage but does not seem to impact the success of the reconstruction. Smoking does not appear to affect the outcomes significantly in this type of reconstruction. Surgeons should consider delaying the reconstruction or using autologous tissue when patients are overweight.
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Affiliation(s)
- L Mata Ribeiro
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar Universitário Lisboa Central, Hospital São José Lisbon, Portugal
| | - Rita P Meireles
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Irís M Brito
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Patrícia M Costa
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar Universitário Lisboa Central, Hospital São José Lisbon, Portugal
| | - Marco A Rebelo
- Department of Plastic and Reconstructive Surgery, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Rui F Barbosa
- Department of Plastic and Reconstructive Surgery, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Miguel P Choupina
- Department of Plastic and Reconstructive Surgery, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Carlos J Pinho
- Department of Plastic and Reconstructive Surgery, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Matilde P Ribeiro
- Department of Plastic and Reconstructive Surgery, Instituto Português de Oncologia do Porto, Porto, Portugal
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Barber MD, Young O, Kulkarni D, Young I, Saleem TB, Fernandez T, Revie E, Dixon JM. No evidence of benefit for laminar flow in theatre for sling-assisted, implant-based breast reconstruction. Surgeon 2021; 19:e112-e116. [DOI: 10.1016/j.surge.2020.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/18/2020] [Accepted: 08/27/2020] [Indexed: 01/25/2023]
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Khan A, Tasoulis MK, Teoh V, Tanska A, Edmonds R, Gui G. Pre-pectoral one-stage breast reconstruction with anterior biological acellular dermal matrix coverage. Gland Surg 2021; 10:1002-1009. [PMID: 33842244 DOI: 10.21037/gs-20-652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background Pre-pectoral implant breast reconstruction (IBR) is gaining popularity. Several techniques using different types of meshes and methods of placement have been described, but no method is currently considered standard. The aim of this study was to evaluate the outcomes of pre-pectoral IBR using acellular dermal matrix (ADM) for anterior implant cover. Methods Retrospective cohort study of consecutive patients who underwent pre-pectoral IBR between November 2016 to August 2018. Data on demographics, adjuvant therapies and operative technique was collected. Postoperative complications, length of hospital stay and secondary cosmetic procedures were recorded. Statistical analysis was performed using descriptive statistics, non-parametric tests and logistic regression. Results One hundred and eleven pre-pectoral IBR were performed in 65 patients. Median age was 41 [interquartile range (IQR), 35-51.5] years, and BMI 22 (IQR, 20.4-24.4) kg/m2. Therapeutic mastectomy was performed in 33 procedures with nipples preservation in 78 cases. The median mastectomy weight and implant volume was 360 (IQR, 220-533) gr, and 445 (IQR, 400-475) cc respectively. At a median follow-up of 18 (IQR, 12-22.5) months, 37 mastectomies had at least 1 complication, but only 12 required surgery. The implant loss rate was 4.5% (5 cases). Lipofilling as secondary procedure was performed in 10.8% of cases. Factors associated with post-operative complications on univariate analysis were nipple preservation (P=0.028), BMI (P=0.01) and implant volume (P=0.027) but these did not remain significant on multivariate analysis. Conclusions Pre-pectoral IBR using ADM for anterior implant cover is associated with low complication and reconstructive failure rate. Patient selection and meticulous surgical technique are important for successful outcome.
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Affiliation(s)
- Ayesha Khan
- Breast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Victoria Teoh
- Breast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Aleksandra Tanska
- Breast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Ruth Edmonds
- Breast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Gerald Gui
- Breast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UK
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Li Y, Wang X, Thomsen JB, Nahabedian MY, Ishii N, Rozen WM, Long X, Ho YS. Research trends and performances of breast reconstruction: a bibliometric analysis. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1529. [PMID: 33313274 PMCID: PMC7729324 DOI: 10.21037/atm-20-3476] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The need for postmastectomy breast reconstruction surgery has increased dramatically, and significant progress has been made both in implant and autologous based breast reconstruction in recent decades. In this paper, we performed a bibliometric analysis with the aim of providing an overview of the developments in breast reconstruction research and insight into the research trends. Methods We searched the Science Citation Index Expanded database and the Web of Science Core Collection for articles published between 1991 to 2018 in the topic domain, using title, abstract, author keywords, and KeyWords Plus. Four citation indicators TCyear, Cyear, C0 and CPPyear were employed to help analyse the identified articles. Results The number of scientific articles in breast reconstruction in this period steadily increased. It took most articles nearly a decade to hit a plateau in terms of citation counts. Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Journal of Plastic Reconstructive and Aesthetic Surgery published the largest number of articles on breast reconstruction. Nine of the top ten most prolific publications were based in the USA. The research highlights related to breast reconstruction were implant-based breast reconstruction, deep inferior epigastric perforator (DIEP) flap breast reconstruction, and superficial inferior epigastric artery (SIEA) flap breast reconstruction. Conclusions This bibliometric analysis yielded data on citation number, publication outputs, categories, journals, institutions, countries, research highlights and tendencies. It helps to picture the panorama of breast reconstruction research, and guide the future research work.
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Affiliation(s)
- Yunzhu Li
- Department of Plastic Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaojun Wang
- Department of Plastic Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China
| | - Jørn Bo Thomsen
- Department of Plastic Surgery, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Denmark
| | - Maurice Y Nahabedian
- Department of Plastic Surgery, Virginia Commonwealth University, Inova Branch, Falls Church, Virginia, USA
| | - Naohiro Ishii
- Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Japan
| | - Warren M Rozen
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Australia
| | - Xiao Long
- Department of Plastic Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China
| | - Yuh-Shan Ho
- Trend Research Centre, Asia University, Taichung, Taiwan
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Immediate implant-based breast reconstruction with acellular dermal matrix after conservative mastectomy: can a more effective alternative be used in the near future? Eur J Surg Oncol 2020; 47:1225-1226. [PMID: 33023794 DOI: 10.1016/j.ejso.2020.09.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/29/2020] [Indexed: 02/03/2023] Open
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Cuomo R. Submuscular and Pre-Pectoral ADM Assisted Immediate Breast Reconstruction: A Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E256. [PMID: 32466619 PMCID: PMC7353845 DOI: 10.3390/medicina56060256] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 12/13/2022]
Abstract
Background and objectives: Breast cancer treatment has deeply changed in the last fifty years. Acellular dermal matrices (ADMs) were introduced for breast reconstruction, with encouraging results, but with conflicting reports too. The present paper aims to summarize the current data on breast reconstruction using acellular dermal matrices. Materials and Methods: We reviewed the literature regarding the use of ADM-assisted implant-based breast reconstruction. Results: The main techniques were analyzed and described. Conclusions: Several authors have recently reported positive results. Nevertheless, an increased complications' rate has been reported by other authors. Higher cost compared to not-ADM-assisted breast reconstruction is another concern.
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Affiliation(s)
- Roberto Cuomo
- Santa Maria Alle Scotte Hospital, Plastic and Reconstructive Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Mario Bracci Street, 53100 Siena, Italy
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