14th. St. Gallen International Breast Cancer Conference, Vienna, Avusturya, 18 - 21 Mart 2015, cilt.24, ss.1-160
Goals: Vicryl mesh can be used for implant based breast
reconstruction but only limited clinical data are available. The aim of
this study whether adding Vicryl mesh in implant based immediate
reconstruction improved outcomes when compared with non-Vicryl
mesh reconstruction.
Methods: Patients undergoing implant based immediate breast
reconstruction at a single university hospital were evaluated.
Aesthetic outcomes and postoperative complications were assessed
and direct comparisions were made between Vicryl mesh and nonVicryl mesh cohorts.
Results: A total of 82 surgical procedures were performed in 70
patients during the study period. Of all the procedures, Vicryl mesh
technique was used in 35 (43%), non-vicryl mesh techniques were
used in 47 (57%) of them. 12 patients (15%) were operated for
recurrent breast cancer had previous history of the whole breast
radiation therapy. Duration of the hospitalization was not different
between two groups (p > 0.05). Overall complications encountered
in 22% of patients and were not different between two groups
(p > 0.05). However, capsular contracture (p = 0.04), inframammary
fold problems (p = 0.04) and bottoming-out (p = 0.04) were all more
frequent in the non-Vicryl mesh group compared with Vicryl mesh
reconstruction. The incidence of the seroma/hematoma, infection,
wound problems/dehiscence, skin necrosis and implant failure were
similar between groups (p > 0.05). Overall and inframammarian fold
aesthetic outcome of immediate implant based breast reconstruction
was higher in the Vicryl mesh than non-Vicryl group (p < 0.001).
Conclusion: Optimizing the inframamarian fold with Vicryl mesh
creates a superior aesthetic result. Its use appears safe and
is associated with less capsular contracture and bottoming-out
and improvement in the inframammary fold appearance, without
increasing postoperative complications.