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Chirurgia 2015 December;28(6):221-6


lingua: Inglese

One-stage immediate implant-based breast reconstruction, using biological matrices after conservative mastectomies: preliminary experience of the University Hospital of Tor Vergata, Rome

Buonomo O. C., Varvaras D., Montuori M., Vanni G., Venditti D., Elia S., Santurro L., Granai A. V., Petrella G., Rossi P.

Department of Surgery, University Hospital of Tor Vergata, Rome, Italy


AIM: Aim of our study was to achieve one-stage immediate implant based breast reconstruction, using biological matrices after conservative mastectomies, evaluate patients outcome and complications, in patients suffering from stage Tis-T1-T2 (<3 cm) breast cancer who underwent conservative mastectomy and reconstructive surgery.
METHODS: The inclusion criteria were: aged 20-65 years; non-smokers; no diabetes or systemic connective disease; BMI<30; Patients should not be subjected to post-mastectomy radiotherapy; informed consent. During our study, through a randomization system, we used two different types of acellular dermal matrices (ADM): SurgiMend® and Tutomesh®.
RESULTS: From February 2012 to March 2014, 22 patients were enrolled, for a total of 38 reconstructions (average age 49 years). Ten patients did not have any mesh-related complications. Four patients showed a dehiscence with bilateral implant exposure, which required removal of the implants; minor wound dehiscence (healing within a month) was observed in 4 patients; 2 patients presented an asymmetry of the inframammary folds and a hematoma was found in two patients.
CONCLUSION: The introduction of the ADM has helped to overcome several reconstructive limitations, allowing an immediate prosthetic reconstruction, after a conservative mastectomy. Complications have been drastically reduced due to an accurate selection of patients. In conclusion, one-stage breast reconstruction with acellular biological matrices, in selected patients, may be a new and realistic frontier in breast surgery, with the real possibility of providing women with breast cancer, a better quality of life compared to the traditional two-stage reconstruction.

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