Evaluation of Prepectoral Breast Tissue Expander Reconstruction Intraoperative Fill: Air or Saline?
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
medline:
31
3
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Staged implant-based breast reconstruction with immediate tissue expanders (TEs) is the most common method of breast reconstruction after mastectomy. TEs traditionally are filled with saline for expansion. Some surgeons have advocated initial intraoperative fill of the TE with air to avoid excess pressure on ischemic mastectomy skin flaps. The purpose of the study was to compare intraoperative air versus saline tissue fills. All patients who underwent prepectoral TE reconstruction after mastectomy from 2017 to 2019 were reviewed. The primary predictive variable was whether saline or air was used for initial tissue expansion. Outcome variables included mastectomy skin necrosis, nipple necrosis, infection, number of expansions, hematoma, and explantation. A total of 53 patients (88 TEs) were included in the study: 28 patients (44 TEs) who underwent initial intraoperative fill with air and 25 patients (44 TEs) who underwent an initial saline fill were assessed. There were no significant differences in complication rates between initial TE fill with saline versus air, including nipple necrosis, wound dehiscence, cellulitis, abscess, or TE removal ( P = 1.0). The number of postoperative TE fills in the initial air fill group was 3.2 compared to 2.7 in the initial saline fill group ( P = 0.27). Prepectoral TE initial fill with air has similar postoperative outcomes compared to initial saline fill. The authors found no benefit to initially filling prepectoral TEs with air intraoperatively. Given the additional effort of exchanging air for saline during the first postoperative fill, there was no clinical advantage of filling prepectoral TEs with air. Therapeutic, III.
Identifiants
pubmed: 36729976
doi: 10.1097/PRS.0000000000009987
pii: 00006534-990000000-01346
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
577e-580eInformations de copyright
Copyright © 2022 by the American Society of Plastic Surgeons.
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