Direct-to-implant, prepectoral breast reconstruction: a single institution experience.
Association of Breast Surgery ePoster Library. Teoh V. 05/13/19; 257192; P150
Dr. Victoria Teoh
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Abstract
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P150
Topic: Surgical techniques
Introduction: Prepectoral, acellular biological matrix (ABM)-assisted, implant-based breast reconstruction (IBBR) is gaining popularity. We report our preliminary institutional outcomes.Method:Retrospective, single-institution, cohort study of patients undergoing single-stage, prepectoral IBBR from 01/2016 to 11/2018. Conversions from previous subpectoral IBBR were excluded. The primary outcome measure was complication rates. Descriptive statistics and non-parametric analyses were performed. Results: 136 patients underwent 202 reconstructions (87 therapeutic/115 risk-reducing). The median age was 44 (26-72) years, median BMI was 22.7 (17.2-36.1) and the median length of hospital stay was 1 day. 16 (11.8%) patients had previous breast surgery with 4 also having previous radiotherapy. Adjuvant radiotherapy was administered in 23 (16.9%) patients. The median implant volume was 420 (115-620) cc. Sheet Surgimend® (n=85) was the most frequently used ABM, followed by meshed Surgimend® (n=77), Meso Biomatrix® (n=27) and Braxon® (n=13).At a median follow-up of 6 months, 61 (30.2%) mastectomies were associated with at least one complication. These included skin-flap necrosis (n=15, 7.4%), nipple necrosis (n=12, 5.9%), haematoma (n=9, 4.5%), infection (n=6, 3%) and capsular contracture (n=8, 4%). Reoperation for complications was required in 28 (13.9%) patients, with removal of implant in 9 (4.5%) cases. On univariate analysis, age (p=0.036), implant size (p=0.003), adjuvant radiotherapy (p=0.026) and incision type (p=0.006) were associated with increased complications rates. Multivariate analysis did not confirm any associations.Conclusion:The results of this study reflect those of current literature. We anticipate participating in the national collaborative study iBra-NET, to produce meaningful data with longer-term oncological, aesthetic and safety outcomes.
Topic: Surgical techniques
Introduction: Prepectoral, acellular biological matrix (ABM)-assisted, implant-based breast reconstruction (IBBR) is gaining popularity. We report our preliminary institutional outcomes.Method:Retrospective, single-institution, cohort study of patients undergoing single-stage, prepectoral IBBR from 01/2016 to 11/2018. Conversions from previous subpectoral IBBR were excluded. The primary outcome measure was complication rates. Descriptive statistics and non-parametric analyses were performed. Results: 136 patients underwent 202 reconstructions (87 therapeutic/115 risk-reducing). The median age was 44 (26-72) years, median BMI was 22.7 (17.2-36.1) and the median length of hospital stay was 1 day. 16 (11.8%) patients had previous breast surgery with 4 also having previous radiotherapy. Adjuvant radiotherapy was administered in 23 (16.9%) patients. The median implant volume was 420 (115-620) cc. Sheet Surgimend® (n=85) was the most frequently used ABM, followed by meshed Surgimend® (n=77), Meso Biomatrix® (n=27) and Braxon® (n=13).At a median follow-up of 6 months, 61 (30.2%) mastectomies were associated with at least one complication. These included skin-flap necrosis (n=15, 7.4%), nipple necrosis (n=12, 5.9%), haematoma (n=9, 4.5%), infection (n=6, 3%) and capsular contracture (n=8, 4%). Reoperation for complications was required in 28 (13.9%) patients, with removal of implant in 9 (4.5%) cases. On univariate analysis, age (p=0.036), implant size (p=0.003), adjuvant radiotherapy (p=0.026) and incision type (p=0.006) were associated with increased complications rates. Multivariate analysis did not confirm any associations.Conclusion:The results of this study reflect those of current literature. We anticipate participating in the national collaborative study iBra-NET, to produce meaningful data with longer-term oncological, aesthetic and safety outcomes.
P150
Topic: Surgical techniques
Introduction: Prepectoral, acellular biological matrix (ABM)-assisted, implant-based breast reconstruction (IBBR) is gaining popularity. We report our preliminary institutional outcomes.Method:Retrospective, single-institution, cohort study of patients undergoing single-stage, prepectoral IBBR from 01/2016 to 11/2018. Conversions from previous subpectoral IBBR were excluded. The primary outcome measure was complication rates. Descriptive statistics and non-parametric analyses were performed. Results: 136 patients underwent 202 reconstructions (87 therapeutic/115 risk-reducing). The median age was 44 (26-72) years, median BMI was 22.7 (17.2-36.1) and the median length of hospital stay was 1 day. 16 (11.8%) patients had previous breast surgery with 4 also having previous radiotherapy. Adjuvant radiotherapy was administered in 23 (16.9%) patients. The median implant volume was 420 (115-620) cc. Sheet Surgimend® (n=85) was the most frequently used ABM, followed by meshed Surgimend® (n=77), Meso Biomatrix® (n=27) and Braxon® (n=13).At a median follow-up of 6 months, 61 (30.2%) mastectomies were associated with at least one complication. These included skin-flap necrosis (n=15, 7.4%), nipple necrosis (n=12, 5.9%), haematoma (n=9, 4.5%), infection (n=6, 3%) and capsular contracture (n=8, 4%). Reoperation for complications was required in 28 (13.9%) patients, with removal of implant in 9 (4.5%) cases. On univariate analysis, age (p=0.036), implant size (p=0.003), adjuvant radiotherapy (p=0.026) and incision type (p=0.006) were associated with increased complications rates. Multivariate analysis did not confirm any associations.Conclusion:The results of this study reflect those of current literature. We anticipate participating in the national collaborative study iBra-NET, to produce meaningful data with longer-term oncological, aesthetic and safety outcomes.
Topic: Surgical techniques
Introduction: Prepectoral, acellular biological matrix (ABM)-assisted, implant-based breast reconstruction (IBBR) is gaining popularity. We report our preliminary institutional outcomes.Method:Retrospective, single-institution, cohort study of patients undergoing single-stage, prepectoral IBBR from 01/2016 to 11/2018. Conversions from previous subpectoral IBBR were excluded. The primary outcome measure was complication rates. Descriptive statistics and non-parametric analyses were performed. Results: 136 patients underwent 202 reconstructions (87 therapeutic/115 risk-reducing). The median age was 44 (26-72) years, median BMI was 22.7 (17.2-36.1) and the median length of hospital stay was 1 day. 16 (11.8%) patients had previous breast surgery with 4 also having previous radiotherapy. Adjuvant radiotherapy was administered in 23 (16.9%) patients. The median implant volume was 420 (115-620) cc. Sheet Surgimend® (n=85) was the most frequently used ABM, followed by meshed Surgimend® (n=77), Meso Biomatrix® (n=27) and Braxon® (n=13).At a median follow-up of 6 months, 61 (30.2%) mastectomies were associated with at least one complication. These included skin-flap necrosis (n=15, 7.4%), nipple necrosis (n=12, 5.9%), haematoma (n=9, 4.5%), infection (n=6, 3%) and capsular contracture (n=8, 4%). Reoperation for complications was required in 28 (13.9%) patients, with removal of implant in 9 (4.5%) cases. On univariate analysis, age (p=0.036), implant size (p=0.003), adjuvant radiotherapy (p=0.026) and incision type (p=0.006) were associated with increased complications rates. Multivariate analysis did not confirm any associations.Conclusion:The results of this study reflect those of current literature. We anticipate participating in the national collaborative study iBra-NET, to produce meaningful data with longer-term oncological, aesthetic and safety outcomes.
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