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1.
Ann Plast Surg ; 88(1): 32-37, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34928243

RESUMO

BACKGROUND AND OBJECTIVES: Despite advances in medicine, infection at the surgical site is an impregnation problem that most surgeons confront. Although studies on the seasonality of infection have been conducted in various areas, no study has confirmed the relationship between seasonal temperature and infection after breast reconstruction. METHODS: From 2008 to 2018, a retrospective study was conducted on patients who underwent implant-based breast reconstruction. Patient demographics, intraoperative data, postoperative data, and temperature information were collected. Temperature differences between cases with and without infection were examined. The differences in the incidence and risk of infection by season were estimated according to the hot season (July to August) and the nonhot season (September to June). RESULTS: Of the 460 cases enrolled, 42 cases developed an infection. Among them, 15 (35.71%) cases developed infection during the hot season (P = 0.003). According to the logistic regression model, the risk of infection was 2.639 times higher in the hot season than in the nonhot season (95% confidence interval, 1.282-5.434; P = 0.008). When the temperature was higher than 25°C, the risk of infection increased by 45.2% for every 1°C increase, which was statistically significant (odds ratio, 1.452; 95% confidence interval, 1.198-1.76; P < 0.001). CONCLUSION: In conclusion, the hot season or average temperatures higher than 25°C increase the risk of infection in patients undergoing implant-based breast reconstruction. It is essential to focus on skin hygiene during the healing of the incision site.


Assuntos
Implantes de Mama , Neoplasias da Mama , Mamoplastia , Implantes de Mama/efeitos adversos , Feminino , Humanos , Mamoplastia/efeitos adversos , Complicações Pós-Operatórias , Estudos Retrospectivos , Estações do Ano , Temperatura
3.
Medicina (Kaunas) ; 57(12)2021 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-34946315

RESUMO

Background and objectives: We conducted this preliminary retrospective study to assess the short-term safety of silicone gel-filled breast implants (SGBIs) that are commercially available in Korean women. Materials and methods :The current retrospective, observational study was conducted in a total of 2612 patients (n = 2612) who underwent augmentation mammaplasty using breast implants at our hospitals between 1 January 2017 and 31 August 2021. Results: Overall, there were a total of 248 cases (9.49%) of postoperative complications; these include 112 cases of early seroma, 52 cases of shape deformation, 32 cases of CC, 12 cases of early hematoma, 12 cases of rupture, 12 cases of infection, 12 cases of stretch deformities with skin excess and 4 cases of rippling. Overall complication-free survival of the breast implant was estimated at 1564.32 ± 75.52 days (95% CI 1416.39-1712.32). Then, the Motiva Ergonomix™ SilkSurface showed the longest survival (1528.00 ± 157.92 days [95% CI 1218.48-1837.56]), followed by the BellaGel® SmoothFine (1458.4 ± 65.76 days [95% CI 1329.56-1587.28]), the Sebbin® Sublimity (1322.00 ± 51.20 days [95% CI 1221.64-1422.32]), the BellaGel® Smooth (1138.72 ± 161.28 days [95% CI 822.6-1454.84), the Mentor® MemoryGel™ Xtra (698.4 ± 52.64 days [95% CI 595.28-801.52]) and the Natrelle® INSPIRA™ (380.00 ± 170.88 days [95% CI 45.04-714.96]) in the decreasing order. On subgroup analysis, both the Motiva ErgonomixTM and Mentor® MemoryGel™ Xtra showed no postoperative complications. However, the BellaGel® SmoothFine, Sebbin® Sublimity and BellaGel® Smooth showed incidences of 8.87%, 4.84% and 1.61%, respectively. A subgroup analysis also showed differences in incidences of postoperative complications between microtextured and smooth breast implants (15.18% vs. 16.67%). Conclusions: In conclusion, our results indicate that diverse types of an SGBI are commercially available and their safety profile varies according to the manufacturer. Plastic surgeons should consider the safety profile of each device in selecting the optimal types of the device for Korean women who are in need of an implant-based augmentation mammaplasty. However, this warrants a single-surgeon, single-center study with long periods of follow-up.


Assuntos
Implante Mamário , Implantes de Mama , Mamoplastia , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Feminino , Seguimentos , Humanos , Mamoplastia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , República da Coreia , Estudos Retrospectivos , Géis de Silicone/efeitos adversos
4.
Medicina (Kaunas) ; 57(11)2021 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-34833432

RESUMO

Breast implantation (BI) is the most common plastic surgery worldwide performed among women. Generally, BI is performed both in aesthetic and oncoplastic procedures. Recently, the prevalence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or breast implant illness (BII) has aroused concerns. As a result, several countries, like Australia, Korea or the United Kingdom, introduced national registries dedicated to the safety and quality of BI surgeries. This narrative review aimed to focus on the clinical challenges, management and the current state of knowledge of BI. Both short and long-term outcomes of BI are determined by various alternatives and differences, which surgeons must consider during the planning and performing breast augmentation along with further complications or risk of reoperation. Proper preoperative decisions and aspects of surgical technique emerged to be equally important. The number of performed breast reconstructions is increasing, providing the finest aesthetic results and improving patient's quality of life. Choice of prosthesis varies according to individual preferences and anatomical variables. A newly diagnosed cases of BIA-ALCL with lacking data on prevention, diagnosis, and treatment are placing it as a compelling medical challenge. Similarly, BII remains one of the most controversial subjects in reconstructive breast surgery due to unspecified diagnostic procedures, and recommendations.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Mamoplastia , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/cirurgia , Mamoplastia/efeitos adversos , Qualidade de Vida
5.
Ann Ital Chir ; 92: 505-508, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795110

RESUMO

AIM: Breast implant-associated anaplastic large cell lymphoma, is a rare cancer. Several theories are speculated that may constitute its etiological factors. None of them has been clearly proven. The case report we present is intended to indicate the leading cause of this disease entity. CASE PRESENTATION: Air samples taken in varying conditions at appropriate intervals by the MicroFlow Alfa 90 device in the operating room during five breast implant surgery were analyzed. Samples were taken four times during each operation. After the air was taken and delivered to the laboratory, the plates were immediately incubated under aerobic conditions. The incubation was carried out for up to 7 days. It has been shown that there is a significant difference between the total number of microorganisms during air intake carried out without and with the supply of air to purify the area in a given area by air recirculation of the operating block and cleaning it from bacteria and particles. No air colony-forming units were grown from air samples taken in the supply. However, from air samples taken without blowing, they were raised in various quantities. CONCLUSION: Laminar free airflow used in operating room conditions significantly reduces the risk of infection of the surgical site, and thus may reduce the risk of developing breast implant-associated anaplastic large cell lymphoma. KEY WORDS: BIA-ALCL ethiological factors, Biofilm, Breast implants, Laminar air flow, Surgical site infections.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Biofilmes , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/epidemiologia , Linfoma Anaplásico de Células Grandes/etiologia , Linfoma Anaplásico de Células Grandes/cirurgia , Salas Cirúrgicas
6.
Am Fam Physician ; 104(5): 500-508, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34783490

RESUMO

Breast implants are used for a wide range of cosmetic and reconstructive purposes. In addition to breast augmentation, implants can be used for postmastectomy breast reconstruction, correction of congenital breast anomalies, breast or chest wall deformities, and male-to-female top surgery. Breast implants may confer significant benefits to patients, but several factors are important to consider preoperatively, including the impact on mammography, future lactation, and potential long-term implant complications (e.g., infection, capsular contracture, rupture, and the need for revision, replacement, or removal). A fundamental understanding of implant monitoring is also paramount to implant use. Patients with silicone breast implants should undergo routine screening for implant rupture with magnetic resonance imaging or ultrasonography completed five to six years postoperatively and then every two to three years thereafter. With the exception of complications, there are no formal recommendations regarding the timing of breast implant removal or exchange. Women with unilateral breast swelling should be evaluated with ultrasonography for an effusion that might indicate breast implant-associated anaplastic large cell lymphoma. There are no specific breast cancer screening recommendations for patients with breast implants, but special mammographic views are indicated to enhance accuracy. Although these discussions are a routine component of consultation and postoperative follow-up for plastic surgeons performing these procedures, family physicians should have a working knowledge of implant indications, characteristics, and complications to better counsel their patients, to ensure appropriate screening, and to coordinate care after surgery.


Assuntos
Implante Mamário , Implantes de Mama , Mama , Efeitos Adversos de Longa Duração , Mastectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Assistência ao Convalescente/métodos , Mama/diagnóstico por imagem , Mama/cirurgia , Implante Mamário/efeitos adversos , Implante Mamário/instrumentação , Implante Mamário/métodos , Implantes de Mama/efeitos adversos , Implantes de Mama/classificação , Feminino , Humanos , Efeitos Adversos de Longa Duração/diagnóstico , Efeitos Adversos de Longa Duração/etiologia , Efeitos Adversos de Longa Duração/prevenção & controle , Masculino , Mamografia/métodos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Reconstrutivos/métodos , Cirurgia de Readequação Sexual/métodos , Cirurgia Plástica/métodos
8.
Acta Chir Plast ; 63(3): 127-138, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34814694

RESUMO

BACKGROUND: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently discovered malignancy of T-cell type, correlated with the use of silicone breast implants. It has been theorized that the etiology may be linked to bacterial growth and long-term inflammation. The afflicted patient usually presents with breast swelling due to peri-implant fluid accumulation. Currently, the diagnosis is achieved by ultrasound, biopsy and testing for certain biomarkers. Following this, the treatment is achieved by complete surgical excision, or by capsulectomy and exchange with smoother surfaced implants. The aim of this study was to identify and report 50 most cited articles related to the field of BIA--ALCL. METHODS: The Web of Science Citation Index was used to identify 325 articles pertaining to BIA-ALCL. The 50 most cited articles among these were included in this study. The title, author name, journal and year of publication, country and institute of origin, level of evidence (LoE), type of study (clinical or basic), and topic of study (pathophysiology, oncologic management, diagnosis, case report and case series) were recorded. RESULTS: This study includes articles from the period 1997-2018 with an average citation rate of 65.5. The majority of the top cited articles (36%; N = 18) were found to be case reports, followed by case series (18%; N = 9), systemic reviews (12%; N = 6) and studies focused on the pathophysiology (16%; N = 8), oncologic management (6%; N = 3), databases (6%; N = 3), diagnostics (4%; N = 2) and informed consent (2%; N = 1). The articles were published across 30 journals and originated from 35 institutes. The United States was found to be the country of origin of most of the studies. While none of the articles achieved LoE 1, many were found to have LoE 4 (N = 11) or 5 (N = 19). Most of the articles (N = 42), were clinical research studies. CONCLUSION: According to this citation analysis, a large fraction of the existing high impact literature on BIA-ALCL is focused on disease monitoring. Through this study, we hope to present a simple educational tool to better appreciate the research in this relatively young field.


Assuntos
Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/etiologia
9.
Surg Infect (Larchmt) ; 22(9): 968-972, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34723647

RESUMO

Background: Breast implant placement is a common operation performed by plastic surgeons, with more than 78,664 implant-based breast reconstructions carried out in the United States in 2016. Infection is a major concern for the reconstructive surgeon, with rates estimated at 2%-4% for implant exchanges. Use of peri-operative antibiotics is variable and provider dependent and is not without risk. Methods: Charts for all women undergoing mastectomy and immediate reconstruction at our institution from July 1, 2011-January 1, 2020 by a single plastic surgeon were reviewed. Patient characteristics, operative technique, and history of radiation, chemotherapy, hormonal treatment, and antibiotic protocols were collected for each patient. The data were analyzed using χ2 and Student t-tests. Results: Chart review was performed for 234 consecutive patients undergoing exchange of breast implants. Patients received only a single dose of peri-operative antibiotics before the first incision without post-operative antibiotics. In these patients, a total of 407 implant exchanges occurred. Post-operative cellulitis was found in 13 instances in 12 patients (infection rate of 3.1%) and was treated successfully with oral antibiotics in 11 of 13 cases. Two patients required operative washout (0.04%). Most of the infections (69%) were found on the side of the cancer. Patients experiencing post-operative infections were more likely to have had adjuvant chemotherapy (p = 0.007) than patients without infection. There was no significant difference between the two groups with regard to neo-adjuvant chemotherapy, radiation to the affected breast, or hormonal therapy or in terms of age, Body Mass Index, or the presence of diabetes mellitus. Intra-operative povidone-iodine (Betadine) swabbing and antibiotic selection did not have an impact on infection risk. Conclusions: A single dose of antibiotics results in sufficiently low rates of infection in patients undergoing breast implant exchange. Adjuvant chemotherapy is a clinically significant risk factor for infection in these patients.


Assuntos
Implantes de Mama , Neoplasias da Mama , Mamoplastia , Antibacterianos/uso terapêutico , Implantes de Mama/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Estudos Retrospectivos , Fatores de Risco
10.
Anticancer Res ; 41(11): 5365-5375, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732406

RESUMO

Reconstructive breast surgery following total or partial mastectomy can be performed using autologous tissues or breast implants, and each has its own set of complications. Most women do not experience significant complications and are highly satisfied but breast reconstruction must consider potential complications from surgical techniques, as well as additional complications that may arise from oncological treatment modalities such as radiation therapy and chemotherapy. The aim of this article is to provide a systemic overview of possible complications that may arise in the course of reconstructive breast surgery. Complications associated with flap-based or implant-based breast reconstruction can be classified as: i) Complications inherent to surgery and common to all, including seroma, bleeding, and hematoma; skin necrosis; and infection, among others. ii) Complications specifically related to reconstruction, such as flap ischemia/necrosis/loss; fat necrosis; implant capsular contracture; implant failure, exposure, or malposition. In conclusion, this overview of possible complications is intended to improve the decision-making process when considering breast reconstruction.


Assuntos
Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Mamoplastia/efeitos adversos , Mastectomia , Complicações Pós-Operatórias/etiologia , Implante Mamário/instrumentação , Tomada de Decisão Clínica , Feminino , Humanos , Mamoplastia/instrumentação , Mastectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Desenho de Prótese , Qualidade de Vida , Medição de Risco , Fatores de Risco , Resultado do Tratamento
11.
Anticancer Res ; 41(11): 5657-5665, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732439

RESUMO

BACKGROUND/AIM: Reduction of postoperative stress is a modern tenet in surgical oncology with the aim of reducing early postoperative lymphopenia. Our prospective study evaluated post-operative immune response at baseline and postoperative day (POD) 1 and 2 after direct-to-implant pre-pectoral (PP) breast reconstruction with titanium-coated polypropylene mesh versus subpectoral (SP) breast reconstruction. PATIENTS AND METHODS: Between January and December 2020, 37 patients were randomized between PP (n=17) or SP (n=16) reconstruction. Baseline and operative data were analyzed. Postoperative pain assessment using numeric pain rating scale (NPRS), and a full blood count with lymphocyte subsets were collected before surgery, and on POD1 and POD2. Data were evaluated by two-way analysis of variance test. RESULTS: Baseline data did not demonstrate any statistical difference. Inter-group analysis did not provide any statistically significant difference in leukocytes, total lymphocytes, and lymphocytes subsets among SP and PP reconstruction groups (p>0.05). However, compared to specificity, the PP group experienced shorter operative time, with a mean difference 30.19 min, lower blood loss (p=0.017), lower rate of postoperative anemia (p=0.039), and a more favorable profile in inter-group pain analysis (p<0.001). CONCLUSION: PP reconstruction with titanium-coated polypropylene mesh does not increase immunological impairment in the early postoperative period when compared with SP reconstruction and provides lower postoperative pain, reduction of operative time, and lower rate of postoperative anemia.


Assuntos
Implante Mamário/instrumentação , Implantes de Mama , Neoplasias da Mama/cirurgia , Mastectomia , Complicações Pós-Operatórias/imunologia , Idoso , Anemia/etiologia , Anemia/prevenção & controle , Implante Mamário/efeitos adversos , Neoplasias da Mama/patologia , Feminino , Humanos , Itália , Pessoa de Meia-Idade , Duração da Cirurgia , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Polipropilenos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Desenho de Prótese , Fatores de Risco , Propriedades de Superfície , Telas Cirúrgicas , Fatores de Tempo , Titânio , Resultado do Tratamento
12.
AMA J Ethics ; 23(9): E679-684, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34710026

RESUMO

Placement of prosthetic breast implants for augmentation or reconstruction is common. Two specific safety concerns are considered in this article: breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and complexes of symptoms known as breast implant illness. In response to a case involving a patient with concerns about BIA-ALCL, this commentary notes that triage, counseling, and treatment are guided in practice by available data in the literature. The commentary also discusses ethical considerations regarding breast implants and related illnesses.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Neoplasias da Mama/cirurgia , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/cirurgia
14.
BMJ Case Rep ; 14(9)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497056

RESUMO

Our patient was a 57-year-old woman with a history of bilateral retropectoral silicone breast augmentation and axillary hyperhidrosis who underwent a bilateral thoracic sympathectomy via video-assisted thoracoscopic surgery by a surgeon at an outside hospital approximately 20 years ago. The left side required an open thoracotomy. Shortly after the surgery, she developed a left-sided Baker 4 capsular contracture and the left implant was noted to be ruptured. Both implants were exchanged. Several years later the patient began to experience progressive fatigue. Work-up revealed a left lung nodule and she underwent a biopsy that confirmed silicone granulomas. It was hypothesised that at the time of her initial thoracotomy the implant was violated resulting in silicone spillage into the thoracic cavity. The patient was referred to our institution for advanced management of her intrathoracic silicosis. The patient underwent bilateral removal of her silicone implants, total capsulectomy and needle-localised removal of her left thoracic silicone masses. She had an uneventful postoperative course with resolution of her fatigue.


Assuntos
Implante Mamário , Implantes de Mama , Mamoplastia , Implantes de Mama/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Pessoa de Meia-Idade , Géis de Silicone/efeitos adversos
15.
Ann Plast Surg ; 87(4): 396-401, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34559710

RESUMO

BACKGROUND: Despite best practices, infection remains the most common complication after breast reconstruction with expanders and implants, ranging from 2% to 29%. Empiric broad-spectrum antibiotics are frequently used in nonsurgical treatment of implant-associated infections in an effort to salvage the reconstruction. Pitfalls of antibiotherapy include adverse events, vascular access site complications, and drug resistance. Our goals were to describe management of implant infections with broad-spectrum antibiotics, review treatment related adverse events, and report on outcomes of therapy. PATIENTS AND METHODS: A retrospective review was carried out to identify patients who were treated with intravenous (IV) antibiotics for periprosthetic infection. Patient characteristics, surgical details, and antibiotic therapy-related adverse events were collected. Eventual outcome related to expander/implant salvage was noted. RESULTS: A total of 101 patients (111 treatment episodes) were identified. Mean duration of antibiotic treatment was 18 days (range, 1-40 days). The most commonly used parenteral treatment was a combination of daptomycin with piperacillin-tazobactam (65%) or an alternative agent (16%). Fifty-nine percent of treatment episodes resulted in salvage of the expander or implant. Thirty-five percent treatment episodes were associated with 1 or more adverse events: diarrhea (12.6%), rash (10%), vaginal candidiasis (3.6%), agranulocytosis/neutropenic fever (3.6%), nausea (3.6%), urinary complaint (0.9%), myositis (0.9%), headache (0.9%), vascular line occlusion (1.8%), deep vein thrombosis (1.8%), and finger numbness (0.9%). No patients developed Clostridium difficile colitis. Five episodes (4%) needed discontinuation of antibiotics because of severe adverse events. The prosthesis was explanted in 3 of the cases of discontinued treatment. CONCLUSIONS: Our findings show favorable outcomes and well-tolerated adverse effects with broad-spectrum parenteral antibiotherapy for periprosthetic infection. However, every effort should be made to deescalate therapy by narrowing the spectrum or limiting the duration, to minimize adverse events and development of bacterial resistance. Treating surgeons need to carefully weigh benefits of therapy and be aware of potential complications that might necessitate discontinuation of treatment.


Assuntos
Implante Mamário , Implantes de Mama , Infecções Relacionadas à Prótese , Antibacterianos/efeitos adversos , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Feminino , Humanos , Infecções Relacionadas à Prótese/tratamento farmacológico , Estudos Retrospectivos
17.
BMJ Open ; 11(9): e045239, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475143

RESUMO

INTRODUCTION: The emphasis on aesthetic outcomes and quality of life (QoL) has motivated surgeons to develop skin-sparing or nipple-sparing mastectomy (SSM/ NSM) for breast cancer treatment or prevention. During the same operation, a so-called immediate breast reconstruction is performed. The breast can be reconstructed by positioning of a breast implant above (prepectoral) or below (subpectoral) the pectoralis major muscle or by using the patients' own tissue (autologous reconstruction). The optimal positioning of the implant prepectoral or subpectoral is currently not clear. Subpectoral implant-based breast reconstruction (IBBR) is still standard care in many countries, but prepectoral IBBR is increasingly performed. This heterogeneity in breast reconstruction practice is calling for randomised clinical trials (RCTs) to guide treatment decisions. METHODS AND ANALYSIS: International, pragmatic, multicentre, randomised, superiority trial. The primary objective of this trial is to test whether prepectoral IBBR provides better QoL with respect to long-term (24 months) physical well-being (chest) compared with subpectoral IBBR for patients undergoing SSM or NSM for prevention or treatment of breast cancer. Secondary objectives will compare prepectoral versus subpectoral IBBR in terms of safety, QoL and patient satisfaction, aesthetic outcomes and burden on patients. Total number of patients to be included: 372 (186 per arm). ETHICS AND DISSEMINATION: This study will be conducted in compliance with the Declaration of Helsinki. Ethical approval has been obtained for the lead investigator's site by the Ethics Committee 'Ethikkommission Nordwest- und Zentralschweiz' (2020-00256, 26 March 2020). The results of this study will be published in a peer-reviewed medical journal, independent of the results, following the Consolidated Standards of Reporting Trials standards for RCTs and good publication practice. Metadata describing the type, size and content of the datasets will be shared along with the study protocol and case report forms on public repositories adhering to the FAIR (Findability, Accessibility, Interoperability, and Reuse) principles. TRIAL REGISTRATION NUMBER: NCT04293146.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Mamoplastia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Mamilos/cirurgia
18.
In Vivo ; 35(5): 2739-2746, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34410963

RESUMO

AIM: This research compares postoperative complication rates with Strattice™, SERAGYN® BR, and TiLOOP® Bra interposition devices for subpectoral implant placement after skin or nipple sparing mastectomy. PATIENTS AND METHODS: 188 breast reconstructions in 157 patients after primary (n=96), secondary (n=71), or prophylactic (n=21) surgery were analyzed regarding major and minor complications. RESULTS: With acellular dermal matrix (ADM) Strattice™, 27.5% major and 27.5% minor complications occurred. Implant loss rates were 27.3% in primary and 30.8% in secondary reconstructions. With SERAGYN® BR, 11.1% major and 13,0% minor complications occurred. Implant losses (6.1%) occurred exclusively in primary reconstructions. With TiLOOP® Bra, 14.9% major and 9.6% minor complications occurred. Implant loss rates were 7.7% in primary and 7.1% in secondary reconstructions. CONCLUSION: ADM was associated with high complication rates in primary and secondary reconstructions. Low complication rates were seen with mesh interposition devices in primary, secondary, and prophylactic reconstructions.


Assuntos
Derme Acelular , Implante Mamário , Implantes de Mama , Neoplasias da Mama , Mamoplastia , Animais , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mamoplastia/efeitos adversos , Mastectomia/efeitos adversos , Polipropilenos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Suínos
20.
Biomed Res Int ; 2021: 3898585, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34337008

RESUMO

Purpose: Capsular formation around breast implants can produce various complications, including erythema, tenderness, discomfort, and breast deformation. Moreover, the capsule is thought to be correlated with breast implant-associated anaplastic large cell lymphoma. The proposed technique of capsule reduction can prevent some of these complications. Thus, the authors suggest a no-touch technique in two-stage, implant-based breast reconstruction. Patients and Methods. This single-center retrospective study evaluated the medical records and digitalized pathological slides of patients who underwent two-stage, implant-based breast reconstruction between February 2018 and May 2019. The selected patients were divided into group A and group B. Group A underwent a no-touch technique that included the following two steps: (1) using a sizer as the frame to create the submuscular and acellular dermal matrix (ADM) pocket for expander insertion and (2) inserting the expander through the funnel. After the second stage of implant insertion, the capsule was harvested for biopsy of the ADM, chest wall, and muscle. Results: This study included 33 breasts (31 patients): 18 in group A and 15 in group B. The capsular thicknesses of the ADM, the chest wall, and the muscle of group A were significantly thinner than those in group B. Pearson's correlation coefficient indicated negative correlations between capsular thickness and age; underlying disease; lesion side; interval of two-stage implant insertion; size of the expander; and radiotherapy, chemotherapy, or hormone therapy. Conclusion: To reduce the incidence of capsular formation following breast reconstruction using prostheses, a no-touch technique that uses a funnel and sizer to avoid implant contact is both efficient and beneficial.


Assuntos
Implantes de Mama/efeitos adversos , Mamoplastia/efeitos adversos , Adulto , Biópsia , Mama/patologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Dispositivos para Expansão de Tecidos
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