Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications.

Background: Breast-conserving therapy with oncoplastic reduction is a useful strategy for partial mastectomy defect reconstruction. The most recently published systematic review of oncoplastic breast reduction outcomes from 2015 showed wound dehiscence in 4.3%, hematoma in 0.9%, infection in 2.8%, and nipple necrosis in 0.9% of patients. We performed a systematic review of oncoplastic breast reduction literature, comparing outcomes and complication rates reported over the past 8 years. Methods: Studies describing the use of oncoplastic breast reduction and discussion of postoperative complications were included. The primary outcome assessed was the postoperative complication rate; secondary outcomes analyzed were rates of margin expansion, completion mastectomy, and delays in adjuvant therapy due to complications. Results: Nine articles met inclusion criteria, resulting in 1715 oncoplastic breast reduction patients. The mean rate of hematoma was 3%, nipple necrosis was 2%, dehiscence was 4%, infection was 3%, and seroma was 2%. The need for re-excision of margins occurred in 8% of patients, and completion mastectomy in 2%. Finally, delay in adjuvant treatment due to a postoperative complication occurred in 4% of patients. Conclusions: Oncoplastic breast reduction is an excellent option for many patients undergoing breast-conserving therapy; however, postoperative complications can delay adjuvant radiation therapy. Results of this systematic literature review over the past 8 years showed a slight increase in complication rate compared to the most recent systematic review from 2015. With increased popularity and surgeon familiarity, oncoplastic breast reduction remains a viable option for reconstruction of partial mastectomy defects despite a slight increase in complication rate.

Development and Characterization of Calmodulin-Based Copolymeric Hydrogels.

Recently, there has been growing interest in harnessing genetically engineered polymers to develop responsive biomaterials, such as hydrogels. Unlike their synthetic counterparts, genetically engineered polymers are produced without the use of toxic reagents and can easily be programmed to incorporate desirable hydrogel properties, including bioactivity, biodegradability, and monodispersity. Herein, we report the development of a copolymeric hydrogel that is based on the calcium-dependent protein, calmodulin (CaM). For our system, CaM and M13, a CaM-binding peptide, were incorporated into genetically engineered polymers with intervening linkers containing cleavable sequences. Spectroscopic and multiple-particle tracking (MPT) studies demonstrate that these polymers self-assemble through calcium-stabilized, noncovalent crosslinking to form a soft viscoelastic material. MPT further revealed that gelation is concentration-dependent. Collagenase digests show that the protein polymers are selectively degraded through specific cleavage. The modularity and stimuli-responsiveness of this system suggest its potential as a flexible scaffold for biomedical applications.