期刊论文详细信息
Journal of Medical Case Reports
Porcine-derived acellular dermal matrix in primary augmentation mammoplasty to minimize implant-related complications and achieve an internal mastopexy: a case series
Andrew Kornstein1 
[1] Museum Mile Surgery Center, 1050 Fifth Avenue, New York, NY 10028, USA
关键词: Strattice;    Internal mastopexy;    Poor soft-tissue support;    Porcine-derived acellular dermal matrix;    Implant malposition;    Capsular contraction;    Breast augmentation;    Acellular dermal matrix;   
Others  :  824816
DOI  :  10.1186/1752-1947-7-275
 received in 2013-04-23, accepted in 2013-10-15,  发布年份 2013
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【 摘 要 】

Introduction

Patients who present for augmentation mammoplasty with poor quality mammary soft-tissue support may be at increased risk for post-operative complications. Non-crosslinked intact porcine-derived acellular dermal matrix (Strattice™ Reconstructive Tissue Matrix, LifeCell Corp., Branchburg, NJ, USA) may enhance soft-tissue support in such patients and reduce implant-related complications, including capsular contracture, rippling, palpability, and malposition. The objective of this case report series was to describe the outcomes of three patients with poor quality mammary soft-tissue support who underwent primary cosmetic breast augmentation with pre-emptive implantation of porcine-derived acellular dermal matrix.

Case presentation

Case 1 concerns a 40-year-old Caucasian woman with post-partum soft tissue laxity and grade II ptosis. Case 2 concerns a 30-year-old Caucasian woman with congenital soft-tissue laxity and grade I + ptosis. Case 3 concerns a 49-year-old Caucasian woman with post-partum and post-weight-loss-induced laxity and grade III ptosis. In all three of our patients, porcine-derived acellular dermal matrix was sutured to the chest wall along the infra-mammary and/or a neo-infra-mammary fold and then laid passively superiorly or sutured under tension to the breast parenchyma or caudal edge of the pectoralis major muscle. In cases 1 and 2, a modified internal mastopexy technique was performed. Suturing the porcine-derived acellular dermal matrix to the posterior aspect of the breast parenchyma and/or caudal pectoralis muscle under appropriate tension in conjunction with radial plication of the porcine-derived acellular dermal matrix created a snug ‘hand-in-glove’ pocket and resulted in only minimal peri-areolar scarring. Case 3 required a vertical scar mastopexy. During a mean of 18 months of follow-up, all three patients had positive outcomes and no complications (that is, infection, hematoma, seroma, rippling, malposition, or capsular contracture). The surgeon and patients were generally highly satisfied with the aesthetic outcome of the breasts.

Conclusions

Pre-emptive use of porcine-derived acellular dermal matrix may be beneficial in patients with primary augmentation with poor quality mammary soft-tissue support.

【 授权许可】

   
2013 Kornstein; licensee BioMed Central Ltd.

【 预 览 】
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【 参考文献 】
  • [1]Gefen A, Dilmoney B: Mechanics of the normal woman’s breast. Technol Health Care 2007, 15:259-271.
  • [2]Samani A, Plewes D: A method to measure the hyperelastic parameters of ex vivo breast tissue samples. Phys Med Biol 2004, 49:4395-4405.
  • [3]Hurwitz DJ, Golla D: Breast reshaping after massive weight loss. Semin Plast Surg 2004, 18:179-187.
  • [4]Howrigan PJ: Reduction and augmentation mammoplasty. Obstet Gynecol Clin North Am 1994, 21:539-549.
  • [5]Escoffier C, de Rigal J, Rochefort A, Vasselet R, Leveque JL, Agache PG: Age-related mechanical properties of human skin: an in vivo study. J Invest Dermatol 1989, 93:353-357.
  • [6]Tebbetts JB: A system for breast implant selection based on patient tissue characteristics and implant-soft tissue dynamics. Plast Reconstr Surg 2002, 109:1396-1409.
  • [7]Vegas MR, Martin Del Yerro JL: Stiffness, compliance, resilience, and creep deformation: understanding implant-soft tissue dynamics in the augmented breast: fundamentals based on materials science. Aesthetic Plast Surg 2013, 37:922-930.
  • [8]van Deventer PV, Graewe FR, Wuringer E: Improving the longevity and results of mastopexy and breast reduction procedures: reconstructing an internal breast support system with biocompatible mesh to replace the supporting function of the ligamentous suspension. Aesthetic Plast Surg 2012, 36:578-589.
  • [9]Ogawa R, Akaishi S, Huang C, Dohi T, Aoki M, Omori Y, Koike S, Kobe K, Akimoto M, Hyakusoku H: Clinical applications of basic research that shows reducing skin tension could prevent and treat abnormal scarring: the importance of fascial/subcutaneous tensile reduction sutures and flap surgery for keloid and hypertrophic scar reconstruction. J Nippon Med Sch 2011, 78:68-76.
  • [10]Bux S, Madaree A: Involvement of upper torso stress amplification, tissue compression and distortion in the pathogenesis of keloids. Med Hypotheses 2012, 78:356-363.
  • [11]Araco A, Caruso R, Araco F, Overton J, Gravante G: Capsular contractures: a systematic review. Plast Reconstr Surg 2009, 124:1808-1819.
  • [12]Schreml S, Heine N, Eisenmann-Klein M, Prantl L: Bacterial colonization is of major relevance for high-grade capsular contracture after augmentation mammaplasty. Ann Plast Surg 2007, 59:126-130.
  • [13]Pajkos A, Deva AK, Vickery K, Cope C, Chang L, Cossart YE: Detection of subclinical infection in significant breast implant capsules. Plast Reconstr Surg 2003, 111:1605-1611.
  • [14]Himsl I, Drinovac V, Lenhard M, Stockl D, Weissenbacher T, Dian D: The use of porcine acellular dermal matrix in silicone implant-based breast reconstruction. Arch Gynecol Obstet 2012, 286:187-192.
  • [15]Vardanian AJ, Clayton JL, Roostaeian J, Shirvanian V, Da Lio A, Lipa JE, Crisera C, Festekjian JH: Comparison of implant-based immediate breast reconstruction with and without acellular dermal matrix. Plast Reconstr Surg 2011, 128:403e-410e.
  • [16]Colwell AS, Damjanovic B, Zahedi B, Medford-Davis L, Hertl C, Austen WG Jr: Retrospective review of 331 consecutive immediate single-stage implant reconstructions with acellular dermal matrix: indications, complications, trends, and costs. Plast Reconstr Surg 2011, 128:1170-1178.
  • [17]Spear SL, Seruya M, Clemens MW, Teitelbaum S, Nahabedian MY: Acellular dermal matrix for the treatment and prevention of implant-associated breast deformities. Plast Reconstr Surg 2011, 127:1047-1058.
  • [18]Nahabedian MY, Spear SL: Acellular dermal matrix for secondary procedures following prosthetic breast reconstruction. Aesthet Surg J 2011, 31(Suppl):38S-50S.
  • [19]Ho G, Nguyen TJ, Shahabi A, Hwang BH, Chan LS, Wong AK: A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction. Ann Plast Surg 2012, 68:346-356.
  • [20]Stewart S, Barr S, Engiles J, Hickok NJ, Shapiro IM, Richardson DW, Parvizi J, Schaer TP: Vancomycin-modified implant surface inhibits biofilm formation and supports bone-healing in an infected osteotomy model in sheep: a proof-of-concept study. J Bone Joint Surg Am 2012, 94:1406-1415.
  • [21]Parra-Ruiz J, Vidaillac C, Rose WE, Rybak MJ: Activities of high-dose daptomycin, vancomycin, and moxifloxacin alone or in combination with clarithromycin or rifampin in a novel in vitro model of Staphylococcus aureus biofilm. Antimicrob Agents Chemother 2010, 54:4329-4334.
  • [22]Adams WP Jr, Rios JL, Smith SJ: Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six-year prospective clinical study. Plast Reconstr Surg 2006, 117:30-36.
  • [23]Maxwell GP, Gabriel A: Acellular dermal matrix in aesthetic revisionary breast surgery. Aesthet Surg J 2011, 31(Suppl):65S-76S.
  • [24]Kashefi P, Honarmand A, Safavi M: Effects of preemptive analgesia with celecoxib or acetaminophen on postoperative pain relief following lower extremity orthopedic surgery. Adv Biomed Res 2012, 1:66.
  • [25]Spear SL, Murphy DK, Slicton A, Walker PS: Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg 2007, 120:8S-16S.
  • [26]Cunningham B: The Mentor Core Study on Silicone MemoryGel Breast Implants. Plast Reconstr Surg 2007, 120:19S-29S. 30S-32S
  • [27]Baker J: Augmentation mammoplasty. Symposium on breast surgery of the breast. 18th edition. Mosby: St. Louis, MO; 1978:256-263.
  • [28]Hipps CJ, Raju R, Straith RE: Influence of some operative and postoperative factors on capsular contracture around breast prostheses. Plast Reconstr Surg 1978, 61:384-389.
  • [29]Gutowski KA, Mesna GT, Cunningham BL: Saline-filled breast implants: a plastic surgery educational foundation multicenter outcomes study. Plast Reconstr Surg 1997, 100:1019-1027.
  • [30]Bengtson BP, Baxter RA: Emerging applications for acellular dermal matrices in mastopexy. Clin Plast Surg 2012, 39:159-166.
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