Treatment of Capsular Contracture in Previously Irradiated Breasts Implants and Expanders with the Use of Porcine Acellular Dermal Matrices: Outcomes and Complications

被引:0
|
作者
Lisa, Andrea Vittorio Emanuele [1 ,2 ,3 ]
Carbonaro, Riccardo [1 ,4 ]
Bottoni, Manuela [1 ]
Colombo, Giulia [1 ]
Gentilucci, Marika [1 ]
Vinci, Valeriano [5 ]
Ostapenko, Edvin [6 ]
Nicosia, Luca [7 ]
De Lorenzi, Francesca [1 ]
Rietjens, Mario [1 ]
机构
[1] IRCCS, European Inst Oncol, Dept Plast & Reconstruct Surg, Via Ripamonti 435, I-20141 Milan, Italy
[2] Univ Milan, Reconstruct & Aesthet Plast Surg Sch, Dept Med Biotechnol & Translat Med BIOMETRA, Via Festa Perdono 7, I-20122 Milan, Italy
[3] Univ Roma Tor Vergata, Dept Surg Sci, PhD Program Appl Med Surg Sci, Cracovia 50, I-00133 Rome, Italy
[4] Univ Milan, Plast & Reconstruct Surg Dept, Via Festa Perdono 7, I-20122 Milan, Italy
[5] Humanitas Univ, Dept Biomed Sci, I-20072 Milan, Italy
[6] Vilnius Univ, Fac Med, MK Ciurlionio G 21, LT-03101 Vilnius, Lithuania
[7] IEO European Inst Oncol IRCCS, Breast Imaging Div, Via Ripamonti, Milan, Italy
关键词
breast reconstruction; radiotherapy; acellular dermal matrix (ADM); RECONSTRUCTION; MASTECTOMY;
D O I
10.3390/jcm13185653
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Radiation therapy is a crucial component of breast cancer treatment. However, it is well known to increase the risk of unsatisfactory cosmetic outcomes and higher complication rates. The aim of this study is to provide further insight into the use of acellular dermal matrices (ADMs) for the prevention of capsular contracture. Materials and Methods: This single-center, retrospective study analyzed irradiated patients who underwent post-mastectomy, ADM-assisted implant reconstructions. Of the 60 patients included, 26 underwent expander-to-implant substitution after radiotherapy (Group A), while 34 required implant replacement due to capsular contracture following radiotherapy (Group B). The primary objective was to evaluate the effectiveness of ADMs in reducing reconstructive failures, complications, and capsular contracture after breast irradiation. Results: We recorded a total of 15 complications and four implant losses. Reconstructive failures were attributed to implant exposure in two cases, full-thickness skin necrosis in one case, and severe Baker grade IV contracture in one case. Both Group A and Group B showed a significant decrease in postoperative Baker grades. US follow-up was used to demonstrate ADM integration with host tissues over time. Conclusions: Based on our findings, the use of ADM in selected cases appears to be a viable option for treating and preventing capsular contracture in irradiated breasts. This approach is associated with relatively low complication rates, a low rate of reconstructive failure, and satisfactory cosmetic outcomes and can be applied both in breast reconstructed with implants and with expanders.
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页数:13
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