The exposed implant in breast reconstructive surgery: a strategy for salvage using acellular dermal matrix and platelet-rich plasma

The exposed implant in breast reconstructive surgery: a strategy for salvage using acellular... The use of breast implants in breast reconstructive surgery is currently the most popular choice among surgeons. Following the introduction of acellular dermal matrices in breast reconstruction, some surgeons proposed their use also in complication repair surgery. In this work, we present our method of treatment of the exposed breast implant using an acellular dermal matrix (Strattice) combined with a series of mesotherapy with platelet-rich plasma (PRP). A group of five women, all treated with radiotherapy, who had a breast implant exposure following post-oncological reconstructive surgery were treated in our unit in the period from March 2011 to November 2012. Only those patients who presented an extrusion area less than 3–3.5 cm, without evident signs of implant infection, were included in this study. After perilesional tissue excision and pocket lavage, the acellular dermal matrix was fixed in the pocket and a new implant was positioned. After the surgery, patients underwent a four-session cycle of mesotherapy with autologous PRP. In four patients, the implant exposure was successfully resolved using the acellular dermal matrix without postoperative complications. One patient developed a prosthesis infection which required its explant and subsequent reconstruction with latissimus dorsi flap. The surgical technique that we describe is proposed, in selected cases, as an alternative to the classical procedures for those patients who are undecided about undergoing further surgery, with long time and demanding demolition. Further studies involving larger case series are necessary. Level of Evidence: Level V, therapeutic study. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

The exposed implant in breast reconstructive surgery: a strategy for salvage using acellular dermal matrix and platelet-rich plasma

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2014 by Springer-Verlag Berlin Heidelberg
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-013-0879-3
Publisher site
See Article on Publisher Site

Abstract

The use of breast implants in breast reconstructive surgery is currently the most popular choice among surgeons. Following the introduction of acellular dermal matrices in breast reconstruction, some surgeons proposed their use also in complication repair surgery. In this work, we present our method of treatment of the exposed breast implant using an acellular dermal matrix (Strattice) combined with a series of mesotherapy with platelet-rich plasma (PRP). A group of five women, all treated with radiotherapy, who had a breast implant exposure following post-oncological reconstructive surgery were treated in our unit in the period from March 2011 to November 2012. Only those patients who presented an extrusion area less than 3–3.5 cm, without evident signs of implant infection, were included in this study. After perilesional tissue excision and pocket lavage, the acellular dermal matrix was fixed in the pocket and a new implant was positioned. After the surgery, patients underwent a four-session cycle of mesotherapy with autologous PRP. In four patients, the implant exposure was successfully resolved using the acellular dermal matrix without postoperative complications. One patient developed a prosthesis infection which required its explant and subsequent reconstruction with latissimus dorsi flap. The surgical technique that we describe is proposed, in selected cases, as an alternative to the classical procedures for those patients who are undecided about undergoing further surgery, with long time and demanding demolition. Further studies involving larger case series are necessary. Level of Evidence: Level V, therapeutic study.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: May 1, 2014

References

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