Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction.

INTRODUCTION: Immediate breast reconstruction (IBR) techniques are rapidly evolving. We compared the results from a single-center implant IBR cohort between subpectoral and prepectoral implants with and without a mesh. METHODS: We analyzed all complications and grade 2-3 complications, the implant loss rate, the surgery time, the length of stay (LOS), patient satisfaction, the interval time to adjuvant therapy and cost, with a comparison between subpectoral and prepectoral implant IBR. RESULTS: Subpectoral implant IBR was carried out in 529 mastectomies (62.0%) and prepectoral in 324, with a significant increase in prepectoral placement in recent years. Mesh was used in 176 prepectoral placements (54.3%). Any grade of complication was reported in 147 mastectomies (17.2%), with a significantly higher rate for prepectoral implant IBR (p = 0.036). Regression analysis showed that prepectoral implant was not significantly associated with any grade of complication or with grade 2-3 complications. Prepectoral implant IBR was associated with a significantly shorter operative time and lower LOS. Grade 2-3 complications were significantly associated with lower satisfaction. Higher costs were significantly associated with the subpectoral placement and mesh. A complication rate predictive score identified five groups with a significant increase in grade 2-3 complications. CONCLUSIONS: Prepectoral-M-IBR increased over time with no difference in complication rates compared to subpectoral-M-IBR. Prepectoral implant placement can be considered a safe technique.

Nanoporous poly(lactide) by olefin metathesis degradation.

We describe an approach to ordered nanoporous poly(lactide) that relies on self-assembly of poly(butadiene)-poly(lactide) (PB-PLA) diblock copolymers followed by selective degradation of PB using olefin metathesis. The block copolymers were obtained by a combination of anionic and ring-opening transesterification polymerizations. The molar mass of each block was tailored to target materials with either a lamellar or cylindrical microphase-separated morphology. Orientation of these nanoscale domains was induced in thin films and monolithic samples through solvent annealing and mechanical deformation, respectively. Selective degradation of PB was achieved by immersing the samples in a solution of Grubbs first-generation catalyst in cyclohexane, a nonsolvent for PLA. Successful elimination of PB was confirmed by size-exclusion chromatography and (1)H NMR spectroscopy. Direct imaging of the resulting nanoporous PLA was obtained by scanning electron microscopy.

Routes to Hydrogen Bonding Chain-End Functionalized Polymers.

The contribution of supramolecular chemistry to polymer science opens new perspectives for the design of polymer materials exhibiting valuable properties and easier processability due to the dynamic nature of non-covalent interactions. Hydrogen bonding polymers can be used as supramolecular units for yielding larger assemblies that possess attractive features, arising from the combination of polymer properties and the responsiveness of hydrogen bonds. The post-polymerization modification of reactive end-groups is the most common procedure for generating such polymers. Examples of polymerizations mediated by hydrogen bonding-functionalized precursors have also recently been reported. This contribution reviews the current synthetic routes toward hydrogen bonding sticker chain-end functionalized polymers.

Hierarchically porous bio-inspired films prepared by combining "breath figure" templating and selectively degradable block copolymer directed self-assembly.

Polymer films with hierarchical micro- and nano-porosities were prepared by combining the fast solvent evaporation "Breath Figure" (BF) method, exhibiting a highly regular honeycomb micro-porous texture, with the additional nanoscale self-assembly of polylactide-block-polystyrene (PLA-b-PS) diblock copolymers, PLA being used thereafter as a sacrificial component for nano-porosity.

Sweet supramolecular elastomers from α,ω-(ß-cyclodextrin terminated) PDMS.

Azido ß-cyclodextrins were attached to propiolate-functionalized polydimethylsiloxanes by metal-free click chemistry. The obtained telechelic copolymers spontaneously produced elastomeric gums. Demixing and supramolecular associations are the driving forces for the construction of these strongly associated (but reversible) physical networks.

Polymeric nanocylinders by combining block copolymer self-assembly and nanoskiving.

A new facile fabrication approach to generate polymeric nanostructures is described. Block copolymers containing immiscible segments can self-assemble to generate ordered nanostructures, such as cylinders of one block in a matrix of the other in the bulk, which can then be sectioned on the nanoscale using a microtome (nanoskiving). Dispersing these sections in a selective solvent for the matrix block results in nanocylinders. In one example, we utilized a poly(N,N-dimethylacrylamide)-block-poly(styrene) (PDMA-PS) copolymer containing 36% by volume of PS. This composition was selected as it self-assembles into cylinders of PS in a matrix of PDMA. Following a previously described procedure, the cylinders were aligned using a channel die. The aligned samples were subsequently sectioned using a microtome containing a diamond knife and dispersed in water, a selective solvent for the PDMA matrix, affording PS nanocylinders with a PDMA corona. This technique allows tuning of nanocylinders without the requirement of specialty fabrication equipment.