Abstract | BACKGROUND: METHODS: A retrospective review was performed on consecutive patients undergoing autologous breast reconstruction or 2-stage expander implant breast reconstruction by the senior author from 2006 through 2015. Patient demographic factors including age, body mass index, history of diabetes, history of smoking, and history of radiation to the breast were collected. Our primary outcome measure was mastectomy skin necrosis. Fisher exact test was used for statistical analysis between the 2 patient cohorts. The treatment patterns of mastectomy skin necrosis were then analyzed. RESULTS: We identified 204 patients who underwent autologous breast reconstruction and 293 patients who underwent 2-stage expander implant breast reconstruction. Patients undergoing autologous breast reconstruction were older, heavier, more likely to have diabetes, and more likely to have had prior radiation to the breast compared with patients undergoing implant-based reconstruction. The incidence of mastectomy skin necrosis was 30.4% of patients in the autologous group compared with only 10.6% of patients in the tissue expander group (P < 0.001). The treatment of this complication differed between these 2 patient groups. In general, those with autologous reconstructions were treated with more conservative means. Although 37.1% of patients were treated successfully with local wound care in the autologous group, only 3.2% were treated with local wound care in the tissue expander group (P < 0.001). Less than half (29.0%) of patients in the autologous group were treated with an operative intervention for this complication compared with 41.9% in the implant-based group (P = 0.25). CONCLUSIONS:
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Authors | Gloria R Sue, Gordon K Lee |
Journal | Annals of plastic surgery
(Ann Plast Surg)
Vol. 80
Issue 5S Suppl 5
Pg. S285-S287
(05 2018)
ISSN: 1536-3708 [Electronic] United States |
PMID | 29489546
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Autografts
- Breast Implants
- Female
- Humans
- Mammaplasty
(adverse effects)
- Mastectomy
(adverse effects)
- Necrosis
- Postoperative Complications
(pathology, therapy)
- Risk Factors
- Skin
(pathology)
- Tissue Expansion
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