Mastectomy flap necrosis after nipple-sparing mastectomy and immediate implant-based reconstruction: An evaluation of tumescence and sharp dissection technique on surgical outcomes.
Adult
Breast Implantation
/ adverse effects
Breast Neoplasms
/ surgery
Dissection
/ adverse effects
Electrocoagulation
/ adverse effects
Female
Humans
Mammaplasty
/ methods
Mastectomy, Subcutaneous
/ methods
Middle Aged
Necrosis
/ etiology
Nipples
/ surgery
Postoperative Complications
/ etiology
Retrospective Studies
Surgical Flaps
/ blood supply
flap necrosis
immediate reconstruction
nipple-sparing mastectomy
tumescence
tumescent technique
Journal
The breast journal
ISSN: 1524-4741
Titre abrégé: Breast J
Pays: United States
ID NLM: 9505539
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
11
12
2018
revised:
04
02
2019
accepted:
05
02
2019
pubmed:
31
7
2019
medline:
9
4
2020
entrez:
31
7
2019
Statut:
ppublish
Résumé
Nipple-sparing mastectomy (NSM) with immediate implant-based reconstruction has better esthetic outcomes and improved patient satisfaction, in addition to being oncologically safe. A known complication of NSM is skin flap necrosis. The use of tumescence and sharp dissection may decrease this complication compared to the standard NSM technique using electrocautery. This is a retrospective review of patients who underwent a NSM between 2014 and 2017 at a regional cancer center. Tumescence with sharp dissection was compared to electrocautery. The primary outcome was skin flap necrosis. The secondary outcomes were operative time and management of the complication. A total of 62 patients underwent a NSM with 116 breasts being operated on. Full-thickness necrosis occurred more frequently in the standard electrocautery group (12.8%) compared to the tumescence and sharp dissection group (1.3%; P = 0.02). Partial-thickness necrosis also occurred more frequently in the standard group (33.3%) compared to the sharp dissection group (13.0%; P = 0.01). The operative time was significantly shorter in the sharp dissection group with the mean (SD) time being 183.5 (48.9) minutes compared to the standard electrocautery group at 202.9 (33.8) minutes (P = 0.03). NSM using tumescence and sharp dissection have a lower rate of the complications of partial- and full-thickness necrosis. Shorter operative time was also seen with the tumescent technique.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1079-1083Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
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