组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2015, Vol. 11 ›› Issue (2): 64-66.doi: 10.3969/j.issn.1673-0364.2015.02.002

• 论著 • 上一篇    下一篇

基于假体和生物膜的乳房重建技术的临床应用研究

吴敏，任玉萍，徐逸，侯楷，随文文，王宁宁，吴毅平   

  1. 华中科技大学同济医学院附属同济医院整形美容外科
  • 发布日期:2020-07-23

The Application of Prosthesis and Dermal Matrices in Breast Reconstruction after Skin-Sparing Mastectomy

WU Min,REN Yuping,XU Yi,HOU Kai,SUI Wenwen,WANG Ningning,WU Yiping   

  1. Institute of Plastic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;
  • Published:2020-07-23
  • Contact: 国家自然科学基金青年基金（81201472）；湖北省重点项目（2012ffa076）

摘要： 目的评价乳腺癌术后即刻应用假体和生物膜进行乳房Ⅰ期重建的临床效果。方法随访2012年至2014年28例保留皮肤的乳房腺体全切术(SSM)患者,其中Ⅰ期用硅胶假体置入胸大肌后生物膜重建乳房下皱襞的患者19例(A组);单纯硅胶假体置入,未使用生物膜的患者9例(B组)。比较两组患者术后1年内,假体外露、假体移位、血肿、包膜挛缩、感染和异物反应等并发症的发生率。结果 A组仅有1例发生血肿(5.26%),其他并发症均未发生;而B组有1例发生假体外露(11.11%)、2例发生假体移位(33.33%)、1例血肿(11.11%)、4例包膜挛缩(44.44%),未发生感染和异物反应。B组假体移位和包膜挛缩率明显高于A组(P<0.05)。术后随访1年,所有病例均无乳腺癌局部复发和远处转移。结论联合应用假体和生物膜重建乳房,形态良好,满意度较高,并发症少,是SSM术后安全有效的乳房重建方法。

关键词: 乳腺癌, 保留皮肤的乳房腺体全切术, 乳房重建, 假体, 生物膜

Abstract: Objective To evaluate the clinical outcome of one-stage breast reconstruction with prosthesis and dermal matrices after skin-sparing mastectomy (SSM). Methods From 2012 to 2014, 28 cases suffered breast cancer were received one stage breast reconstruction after SSM, and were divided into group A and group B. The silicone prosthesis and dermal matrices was performed in group A (n=19) to reshape the breast and strengthen the inframammary fold, and silicone prosthesis without dermal matrices was used in group B (n=9). The incidence of complication was compared between two groups 1 year after operation. Results In group A, only 1 case (5.26%) with hematoma was observed. In group B, 1 case (11.11%) with prosthesis exposure, 3 cases (33.33%) with prosthesis shelloft, 1 case (11.11%) with hematoma and 4 cases (44.44%) with capsular contracture were observed. There were significant differences between two groups in the evidence of prosthesis shelloft and capsular contracture (P<0.05). All the patients were followed up for 1 year, no local recurrence and distant metastasis were observed. Conclusion Combination with prosthesis and dermal matrices had a better breast shape, higher satisfaction and less complication. It was a safer and more effective method of breast reconstruction.

Key words: Breast cancer, Skin-sparing mastectomy, Breast reconstruction, Prosthesis, Dermal matrices

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