Outcomes in Implant-based Breast Reconstruction Utilizing Biosynthetic Mesh: A Meta-analysis

被引：0
作者：
Arnautovic, Alisa [1 ]
Williams, Sonya [2 ]
Ash, Makenna [2 ]
Menon, Ambika [3 ]
Shauly, Orr [3 ]
Losken, Albert [3 ]
机构：
[1] Emory Univ, Sch Med, Dept Surg, Atlanta, GA USA
[2] Emory Univ, Sch Med, Atlanta, GA USA
[3] Emory Univ, Sch Med, Dept Surg, Div Plast & Reconstruct Surg, Atlanta, GA USA
来源：
AESTHETIC SURGERY JOURNAL | 2025年 / 45卷 / 04期
关键词：
ABSORBABLE MESH; SYNTHETIC MESH; FOLLOW-UP; ADM; PLACEMENT; SURGERY; MATRIX; COST;
D O I：
10.1093/asj/sjaf002
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Background Biosynthetic mesh has become increasingly popular for immediate breast cancer implant-based reconstruction as an alternative to acellular dermal matrix for soft tissue support.Objectives The aim of this meta-analysis was to investigate the various biosynthetic mesh options available as well as complications and outcomes.Methods PubMed (US National Library of Medicine, Bethesda, MD), MEDLINE (US National Library of Medicine), and Embase (Elsevier, Amsterdam, the Netherlands) were systematically reviewed for studies investigating TIGR (Novus Scientific, Uppsala, Sweden), Vicryl (Ethicon, Inc., Raritan, NJ), PDO (Poly-Med, Anderson, SC), TiLOOP (PFM Medical, Cologne, Germany), Durasorb (Integra LifeSciences, Princeton, NJ), and Galaflex (BD, Franklin Lakes, NJ) meshes, and their associated outcomes. The meta-analysis was completed in accordance with PRISMA guidelines and was performed to determine overall complication rates in patients who underwent breast reconstruction in which a mesh was used. Data were combined by a pooling of proportional outcomes as is inherent to meta-analysis. The heterogeneity of included studies was assessed in terms of Q and I2 statistics.Results A total of 24 studies investigating 6 different types of mesh in 2167 individual breasts undergoing implant reconstruction were included. Summary effect sizes were calculated for the complications. The pooled rate of seroma formation was 5.26% (Q = 23.81%, I2 = 37.01%) reported in 13 studies, hematoma formation was 2.5% (Q = 0.25%, I2 = 58.27%) reported in 9 studies, skin necrosis was 5.5% (Q = 2.86%, I2 = 423.78%) reported in 10 studies, infection rate was 4.8% (Q = 6.02%, I2 = 149.34%) in 21 studies, and implant loss was 3.85% (Q = 6.55%, I2 = 129.07%) reported in 10 studies.Conclusions Overall, although differences in mesh characteristics exist, the reported rate of complications is low. Biosynthetic mesh options should be taken into consideration in breast reconstruction given their demonstrated safety, significant cost advantage, and potential decrease in short-term complications in comparison to acellular dermal matrix.
引用
收藏
页码：365 / 372
页数：8
相关论文
共 54 条
  • [1] Reitsamer R, Peintinger F, Klaassen-Federspiel F, Sir A., Prepectoral direct-to-implant breast reconstruction with complete ADM or synthetic mesh coverage—36-months follow-up in 200 reconstructed breasts, Breast, 48, pp. 32-37, (2019)
  • [2] Dyrberg DL, Bille C, Gunnarsson GL, Sorensen JA, Thomsen JB., Visualized pre- and subpectoral implant placement for immediate breast reconstruction, Gland Surg, 8, pp. S251-S254, (2019)
  • [3] Cuomo R., Submuscular and pre-pectoral ADM assisted immediate breast reconstruction: a literature review, Medicina (Kaunas), 56, (2020)
  • [4] Hallberg H, Rafnsdottir S, Selvaggi G, Et al., Benefits and risks with acellular dermal matrix (ADM) and mesh support in immediate breast reconstruction: a systematic review and meta-analysis, J Plast Surg Hand Surg, 52, pp. 130-147, (2018)
  • [5] Faulkner HR, Shikowitz-Behr L, McLeod M, Wright E, Hulsen J, Austen WG, The use of absorbable mesh in implant-based breast reconstruction: a 7-year review, Plast Reconstr Surg, 146, pp. 731e-736e, (2020)
  • [6] Haynes DF, Kreithen JC., Vicryl mesh in expander/implant breast reconstruction: long-term follow-up in 38 patients, Plast Reconstr Surg, 134, pp. 892-899, (2014)
  • [7] Bai J, Ferenz S, Fracol M, Kim JYS., A comparison of capsular contracture rates after implant-based breast reconstruction using ADM versus synthetic mesh, Aesthet Surg J Open Forum, 6, (2024)
  • [8] Scheflan M, Colwell AS., Tissue reinforcement in implant-based breast reconstruction, Plast Reconstr Surg Glob Open, 2, (2014)
  • [9] Tessler O, Reish RG, Maman DY, Smith BL, Austen WG, Beyond biologics: absorbable mesh as a low-cost, low-complication sling for implant-based breast reconstruction, Plast Reconstr Surg, 133, pp. 90e-99e, (2014)
  • [10] Buccheri EM, Villanucci A, Mallucci P, Bistoni G, de Vita R., Synthetic reabsorb-able mesh (GalaFLEX) as soft tissue adjunct in breast augmentation revision surgery, Aesthet Surg J, 43, pp. 559-566, (2023)
123456