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Immediate Breast Reconstruction Following Mastectomy Is as Safe as Mastectomy Alone

Immediate Breast Reconstruction Following Mastectomy Is as Safe as Mastectomy Alone Abstract • We evaluated wound complications and potential risk factors after mastectomy with immediate breast reconstruction and compared them with similar data after modified radical mastectomy. The incidences of infection, seroma, hematoma, and epidermolysis were compared among 395 patients (305 with modified radical mastectomies and 90 with mastectomy with immediate breast reconstruction) from Virginia Mason Medical Center, Seattle, Wash, between 1983 and 1989. Obesity, age (60 years or older), smoking, antibiotics, and wound drainage were examined as possible risk factors. There were more wound complications in the modified radical mastectomy group (48% vs 31%), and specifically, more seromas (30% vs 13%). In the modified radical mastectomy group, age of 60 years or older was associated with seroma and infection, drainage greater than 30 mL per day (at time of drain removal) with seroma, and smoking with epidermolysis. In the mastectomy with immediate breast reconstruction group, obesity was associated with seroma and epidermolysis. We conclude that mastectomy with immediate breast reconstruction appears to be as safe as modified radical mastectomy alone with respect to wound complications. (Arch Surg. 1990;125:1303-1308) References 1. Feller WF, Holt R, Spear S, Little J. Modified radical mastectomy with immediate breast reconstruction . Am Surg . 1986;52:129-133. 2. Frazier TG, Noone RB. An objective analysis of immediate simultaneous reconstruction in the treatment of primary carcinoma of the breast . Cancer . 1985;55:1202-1205.Crossref 3. Noone RB, Murphy JB, Spear SL, Little JW. A 6-year experience with immediate reconstruction after mastectomy for cancer . Plast Reconstr Surg . 1985;76:258-269.Crossref 4. Webster DJ, Mansel RE, Hughes LE. Immediate reconstruction of the breast after mastectomy: is it safe? Cancer . 1984;53:1416-1419.Crossref 5. National Institutes of Health Consensus Development Panel. Health Implications of Obesity . US Government Printing Office; 1985;5:1-7. 6. Feigenberg Z, Zer M, Dintsman M. Comparison of postoperative complications following radical and modified radical mastectomy . World J Surg . 1977;1:207-211.Crossref 7. Hayes JA, Bryan RM. Wound healing following mastectomy . Aust N Z J Surg . 1984;54:25-27.Crossref 8. Corneillie P, Gruwez JA, Lerut T, Van Elst F. Early and late postoperative sequelae after surgery for carcinoma of the breast . Acta Chir Belg . 1984;84:227-231. 9. Budd DC, Cochran RC, Sturtz DL, Fouty WJ. Surgical morbidity after mastectomy operations . Am J Surg . 1978;135:218-220.Crossref 10. Simmons BP. Guidelines for prevention of surgical wound infections . Infect Control. 1982;3:188-196. 11. Platt R, Zaleznik DF, Hopkins CC, et al. Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery . N Engl J Med . 1990;322:153-160.Crossref 12. Ad Hoc Committee of the Committee on Trauma, Division of Medical Sciences, National Academy of Sciences National Research Council. Postoperative wound infections, the incidence of ultraviolet irradiation of the operating room and various other factors . Ann Surg . 1964;160( (suppl) ):1-192.Crossref 13. Tejler G, Aspegren K. Complications and hospital stay after surgery for breast cancer: a prospective study of 385 patients . Br J Surg . 1985;72:542-544.Crossref 14. Eaglstein WH. Wound healing and aging . Dermatol Clin . 1986;4:481-484. 15. Craig S, Rees TD. The effect of smoking on experimental skin flaps in hamsters . Plast Reconstr Surg . 1985;75:842-846.Crossref 16. Lawrence WT, Murphy RC, Robson MC, Heggers JP. The detrimental effect of cigarette smoking on flap survival: an experimental study in the rat . Br J Plast Surg . 1984;37:216-219.Crossref 17. Rees TD, Liverett DM, Guy CL. The effect of cigarette smoking on skin flap survival in the facelift patient . Plast Reconstr Surg . 1984;73:911-915.Crossref 18. Reus WF, Robson MC, Zachary L, Heggers JP. Acute effects of tobacco smoking on blood flow in the cutaneous microcirculation . Br J Plast Surg . 1984;37:213-215.Crossref 19. Say CS, Donegan WA. A biostatistical evaluation of complications from mastectomy . Surg Gynecol Obstet . 1974;138:370-376. 20. Albo RJ, Gruber R, Kahn R. Immediate breast reconstruction after modified mastectomy for carcinoma of the breast . Am J Surg . 1980;140:131-138.Crossref 21. Johnson CH, van Heerden JA, Donahue JH, Martin K, Jackson IT, Ilstrup DM. Oncological aspects of immediate breast reconstruction following mastectomy for malignancy . Arch Surg . 1989;124:819-824.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Immediate Breast Reconstruction Following Mastectomy Is as Safe as Mastectomy Alone

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References (23)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1990.01410220087012
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Abstract

Abstract • We evaluated wound complications and potential risk factors after mastectomy with immediate breast reconstruction and compared them with similar data after modified radical mastectomy. The incidences of infection, seroma, hematoma, and epidermolysis were compared among 395 patients (305 with modified radical mastectomies and 90 with mastectomy with immediate breast reconstruction) from Virginia Mason Medical Center, Seattle, Wash, between 1983 and 1989. Obesity, age (60 years or older), smoking, antibiotics, and wound drainage were examined as possible risk factors. There were more wound complications in the modified radical mastectomy group (48% vs 31%), and specifically, more seromas (30% vs 13%). In the modified radical mastectomy group, age of 60 years or older was associated with seroma and infection, drainage greater than 30 mL per day (at time of drain removal) with seroma, and smoking with epidermolysis. In the mastectomy with immediate breast reconstruction group, obesity was associated with seroma and epidermolysis. We conclude that mastectomy with immediate breast reconstruction appears to be as safe as modified radical mastectomy alone with respect to wound complications. (Arch Surg. 1990;125:1303-1308) References 1. Feller WF, Holt R, Spear S, Little J. Modified radical mastectomy with immediate breast reconstruction . Am Surg . 1986;52:129-133. 2. Frazier TG, Noone RB. An objective analysis of immediate simultaneous reconstruction in the treatment of primary carcinoma of the breast . Cancer . 1985;55:1202-1205.Crossref 3. Noone RB, Murphy JB, Spear SL, Little JW. A 6-year experience with immediate reconstruction after mastectomy for cancer . Plast Reconstr Surg . 1985;76:258-269.Crossref 4. Webster DJ, Mansel RE, Hughes LE. Immediate reconstruction of the breast after mastectomy: is it safe? Cancer . 1984;53:1416-1419.Crossref 5. National Institutes of Health Consensus Development Panel. Health Implications of Obesity . US Government Printing Office; 1985;5:1-7. 6. Feigenberg Z, Zer M, Dintsman M. Comparison of postoperative complications following radical and modified radical mastectomy . World J Surg . 1977;1:207-211.Crossref 7. Hayes JA, Bryan RM. Wound healing following mastectomy . Aust N Z J Surg . 1984;54:25-27.Crossref 8. Corneillie P, Gruwez JA, Lerut T, Van Elst F. Early and late postoperative sequelae after surgery for carcinoma of the breast . Acta Chir Belg . 1984;84:227-231. 9. Budd DC, Cochran RC, Sturtz DL, Fouty WJ. Surgical morbidity after mastectomy operations . Am J Surg . 1978;135:218-220.Crossref 10. Simmons BP. Guidelines for prevention of surgical wound infections . Infect Control. 1982;3:188-196. 11. Platt R, Zaleznik DF, Hopkins CC, et al. Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery . N Engl J Med . 1990;322:153-160.Crossref 12. Ad Hoc Committee of the Committee on Trauma, Division of Medical Sciences, National Academy of Sciences National Research Council. Postoperative wound infections, the incidence of ultraviolet irradiation of the operating room and various other factors . Ann Surg . 1964;160( (suppl) ):1-192.Crossref 13. Tejler G, Aspegren K. Complications and hospital stay after surgery for breast cancer: a prospective study of 385 patients . Br J Surg . 1985;72:542-544.Crossref 14. Eaglstein WH. Wound healing and aging . Dermatol Clin . 1986;4:481-484. 15. Craig S, Rees TD. The effect of smoking on experimental skin flaps in hamsters . Plast Reconstr Surg . 1985;75:842-846.Crossref 16. Lawrence WT, Murphy RC, Robson MC, Heggers JP. The detrimental effect of cigarette smoking on flap survival: an experimental study in the rat . Br J Plast Surg . 1984;37:216-219.Crossref 17. Rees TD, Liverett DM, Guy CL. The effect of cigarette smoking on skin flap survival in the facelift patient . Plast Reconstr Surg . 1984;73:911-915.Crossref 18. Reus WF, Robson MC, Zachary L, Heggers JP. Acute effects of tobacco smoking on blood flow in the cutaneous microcirculation . Br J Plast Surg . 1984;37:213-215.Crossref 19. Say CS, Donegan WA. A biostatistical evaluation of complications from mastectomy . Surg Gynecol Obstet . 1974;138:370-376. 20. Albo RJ, Gruber R, Kahn R. Immediate breast reconstruction after modified mastectomy for carcinoma of the breast . Am J Surg . 1980;140:131-138.Crossref 21. Johnson CH, van Heerden JA, Donahue JH, Martin K, Jackson IT, Ilstrup DM. Oncological aspects of immediate breast reconstruction following mastectomy for malignancy . Arch Surg . 1989;124:819-824.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Oct 1, 1990

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