Optimization of Prepectoral Breast Reconstruction

被引:22
作者
Cuomo, Roberto [1 ]
Giardino, Francesco Ruben [1 ]
Neri, Alessandro [2 ]
Nisi, Giuseppe [1 ]
Brandi, Cesare [1 ]
Zerini, Irene [1 ]
Jingjian, Han [3 ]
Grimaldi, Luca [1 ]
机构
[1] Univ Siena, Dept Med Surg & Neurosci, S Maria Scone Hosp, Unit Plast & Reconstruct Surg, Siena, Italy
[2] Univ Siena, Dept Med Surg & Neurosci, S Maria Scone Hosp, Unit Gen & Ontol Surg, Siena, Italy
[3] Jining Med Univ, Jining First Peoples Hosp, Jining City, Peoples R China
关键词
Breast reconstruction; Braxon; Acellular dermal matrix; Breast; Breast cancer;
D O I
10.1159/000506347
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: Acellular dermal matrix (ADM) were introduced in the early 2000s and more recently permitted new protocols for breast reconstruction allowing a short operative time with improved outcomes until the new muscle-sparing breast reconstruction proposed in 2014 using the Braxon (R) ADM. The aim of this research is to propose a technique to improve the aesthetic outcome using Braxon ADM with prepectoral implants. Materials and Methods: The enrolled patients were submitted to a nipple skin-sparing mastectomy leaving 1 additional centimeter of subcutis on the proximal part of the upper pole of the breast (see Surgical Technique). Aesthetic outcomes were compared to those obtained with traditional breast reconstruction with prosthesis and the Braxon ADM placed in the prepectoral space. Mean values of aesthetic outcomes were analyzed using the Student t test, and the kappa test was used to analyze interobserver variability. Results: The overall aesthetic score was improved of 29.6% of the patients; in particular the most improved score was that for contour (+98.01%). Statistical significance was found for contour, upper pole definition, and total score average (p < 0.05).The kappa test showed interobserver variability with a good level of agreement on contour (kappa = 0.832). Conclusions: The proposed technique has allowed attainment of good results in terms of aesthetic outcomes. In a small sample we did not register any particular complications but we verified a better satisfaction on the evaluation of the aesthetic result (level of evidence: 3).
引用
收藏
页码:36 / 42
页数:7
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