Multicentre audit of Prepectoral Implant based immediate breast reconstruction using Braxon
Association of Breast Surgery ePoster Library. Jafferbhoy S. 05/15/17; 166235; P089
Sadaf Jafferbhoy
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Abstract
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Introduction:
Immediate breast reconstruction using subpectoral implant and acellular dermal matrix (ADM) has become standard practice in the UK. Detaching pectoralis major from the chest wall in the subpectoral technique is associated with postoperative pain. Prepectoral implant based reconstruction using a novel preshaped ADM mesh ''BRAXON'' has recently been introduced in the UK. We report the early experience from 3 Breast Units using this technique in immediate breast reconstruction.
Methods:
Patients requiring immediate breast reconstruction suitable for Braxon from December 2015 to October 2016 were included. Information regarding demographics, indication for surgery, operative details, immediate and delayed complications and follow up details were collected and analysed.
Results:
A total of 78 cases were identified of which 13 were bilateral procedures. Their BMI ranged from 19-39 kg/m2. Four patients were diabetic and 3 were smokers. Implant size used ranged from 200-535cc and the average length of stay in the hospital was 1.6 days. During the median follow up of 28 weeks, 16 patients (20%) had seromas aspirated and 20 patients (25%) required a further course of antibiotics. Seventeen patients (22%) were readmitted within 30 days and 8 implants (10%) were explanted due to infection (2 bilateral procedures).
Conclusion:
Our early experience using this novel technique has shown the complication rates comparable to the traditional subpectoral technique. Post-operative recovery is quicker and animation deformity is eliminated as pectoralis muscle is spared. However, long term studies are required to assess rippling and impact from adjuvant treatment.
Immediate breast reconstruction using subpectoral implant and acellular dermal matrix (ADM) has become standard practice in the UK. Detaching pectoralis major from the chest wall in the subpectoral technique is associated with postoperative pain. Prepectoral implant based reconstruction using a novel preshaped ADM mesh ''BRAXON'' has recently been introduced in the UK. We report the early experience from 3 Breast Units using this technique in immediate breast reconstruction.
Methods:
Patients requiring immediate breast reconstruction suitable for Braxon from December 2015 to October 2016 were included. Information regarding demographics, indication for surgery, operative details, immediate and delayed complications and follow up details were collected and analysed.
Results:
A total of 78 cases were identified of which 13 were bilateral procedures. Their BMI ranged from 19-39 kg/m2. Four patients were diabetic and 3 were smokers. Implant size used ranged from 200-535cc and the average length of stay in the hospital was 1.6 days. During the median follow up of 28 weeks, 16 patients (20%) had seromas aspirated and 20 patients (25%) required a further course of antibiotics. Seventeen patients (22%) were readmitted within 30 days and 8 implants (10%) were explanted due to infection (2 bilateral procedures).
Conclusion:
Our early experience using this novel technique has shown the complication rates comparable to the traditional subpectoral technique. Post-operative recovery is quicker and animation deformity is eliminated as pectoralis muscle is spared. However, long term studies are required to assess rippling and impact from adjuvant treatment.
Introduction:
Immediate breast reconstruction using subpectoral implant and acellular dermal matrix (ADM) has become standard practice in the UK. Detaching pectoralis major from the chest wall in the subpectoral technique is associated with postoperative pain. Prepectoral implant based reconstruction using a novel preshaped ADM mesh ''BRAXON'' has recently been introduced in the UK. We report the early experience from 3 Breast Units using this technique in immediate breast reconstruction.
Methods:
Patients requiring immediate breast reconstruction suitable for Braxon from December 2015 to October 2016 were included. Information regarding demographics, indication for surgery, operative details, immediate and delayed complications and follow up details were collected and analysed.
Results:
A total of 78 cases were identified of which 13 were bilateral procedures. Their BMI ranged from 19-39 kg/m2. Four patients were diabetic and 3 were smokers. Implant size used ranged from 200-535cc and the average length of stay in the hospital was 1.6 days. During the median follow up of 28 weeks, 16 patients (20%) had seromas aspirated and 20 patients (25%) required a further course of antibiotics. Seventeen patients (22%) were readmitted within 30 days and 8 implants (10%) were explanted due to infection (2 bilateral procedures).
Conclusion:
Our early experience using this novel technique has shown the complication rates comparable to the traditional subpectoral technique. Post-operative recovery is quicker and animation deformity is eliminated as pectoralis muscle is spared. However, long term studies are required to assess rippling and impact from adjuvant treatment.
Immediate breast reconstruction using subpectoral implant and acellular dermal matrix (ADM) has become standard practice in the UK. Detaching pectoralis major from the chest wall in the subpectoral technique is associated with postoperative pain. Prepectoral implant based reconstruction using a novel preshaped ADM mesh ''BRAXON'' has recently been introduced in the UK. We report the early experience from 3 Breast Units using this technique in immediate breast reconstruction.
Methods:
Patients requiring immediate breast reconstruction suitable for Braxon from December 2015 to October 2016 were included. Information regarding demographics, indication for surgery, operative details, immediate and delayed complications and follow up details were collected and analysed.
Results:
A total of 78 cases were identified of which 13 were bilateral procedures. Their BMI ranged from 19-39 kg/m2. Four patients were diabetic and 3 were smokers. Implant size used ranged from 200-535cc and the average length of stay in the hospital was 1.6 days. During the median follow up of 28 weeks, 16 patients (20%) had seromas aspirated and 20 patients (25%) required a further course of antibiotics. Seventeen patients (22%) were readmitted within 30 days and 8 implants (10%) were explanted due to infection (2 bilateral procedures).
Conclusion:
Our early experience using this novel technique has shown the complication rates comparable to the traditional subpectoral technique. Post-operative recovery is quicker and animation deformity is eliminated as pectoralis muscle is spared. However, long term studies are required to assess rippling and impact from adjuvant treatment.
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