212 posters, 10 topics, 5 sessions, 754 authors, 237 institutions
ePostersLive by SciGen Technologies S.A. All rights reserved.
The AAPS 101st Annual Meeting
29 April – 2 May, 2023 | Chicago, IL
D103
Prepectoral Direct-to-implant Versus Staged Tissue Expander Reconstruction: Comparison Of Complications
Part of Topic
Breast Reconstruction
Prepectoral Direct-to-Implant versus Staged Tissue Expander Reconstruction: Comparison of Complications
Emily R. Finkelstein, MD; Natalia Vidal Laureano, MD; Armina Azizi, MD; Taylor Smartz, BS; CaiweiZheng, MD; Zubin Panthaki, MD;
John Oeltjen, MD, PhD; Wrood Kassira, MD
University of Miami Miller School of Medicine, Department of Surgery, Division of Plastic Surgery, Miami, Florida
BACKGROUND
•Direct-to-implant (DTI) reconstruction has multiple advantages over a staged tissue expander (TE) approach.
•Prepectoral DTI may be less frequently employed due to limited comparative studies in the literature.
•This study compares postoperative outcomes for DTI versus TE reconstruction in the prepectoral plane.
METHODS
•Retrospective review of 348 patients that received immediate prepectoral breast reconstruction.
•Risk factors and the rate of six separate complications were compared between patients that received DTI versus TE reconstruction up to one postoperative year.
RESULTS
•The incidence of any complication and postoperative wounds (both major and minor) was significantly greater in patients that received DTI reconstruction (Table 1).
•In the DTI cohort only, patients with any complication (711g vs 596g; p<0.0077) and postoperative wounds (739g vs 601g; p<0.0058) had significantly greater mastectomy resection weights than the patients without these specific complications.
•Final implant volume did not have a significant impact on the incidence of complications, apart from infection in the DTI cohort (p<0.0413).
•Compared to extra-thick ADM, medium-thickness ADM was associated with significantly fewer overall complications (p<0.0011),infectious complications(p<0.0408), and wound healing complications (p<0.0001) (Figure 1).
•Medium-thickness ADM also had fewer overall (p<0.0013) and wound healing complications (p<0.0011) than thick ADM.
CONCLUSIONS
•Rates of most major complications are comparable between patients that received prepectoral DTI and staged TE breast reconstruction.
•The authors encourage prepectoral DTI reconstruction with medium or thick ADM over a staged TE approach in patients with moderate to low mastectomy resection weights that are to receive comparable or smaller sizes of implants.