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De novo experience of resorbable woven mesh in immediate breast reconstruction post-mastectomy

European Journal of Plastic Surgery volume 40, pages 17–22 (2017)Cite this article

Abstract

Background

Implant based reconstruction (IBR) is the most common form of breastreconstruction. IBR has advantages; uncomplicated surgery, no donor site and goodaesthetic outcome. However, disadvantages include infection with implant loss andphysical limitation to the size of breast which can be used. The use of surgical matricesto increase the size of implants used has gained in popularity, however concernsregarding increased complication rates exists. Here we describe our initial experienceusing a resorbable mesh in post mastectomy patients.

Methods

Post mastectomy patients after cancer surgery or for risk reducing surgerywere examined. We examined our initial experience over an 18 month period ofpatients undergoing reconstruction with the use of resorbable mesh and implant basedreconstruction. Patients were followed for major or minor complications including flap necrosis, implant loss, haematoma, seroma and infection rates.

Results

Few major complications were encountered. There were no instances of flap necrosis or haematoma formation. However, 5 reconstructed breasts (n=74, 6.7%)resulted in loss of the implant due to infection. These losses were associated withpatients who were either current or ex-smokers, or in patients who had or wereundergoing either radiation or chemotherapy. Minor complications such as superficialwound infections were seen in 8 of 74 (10.8%) reconstructed breasts. The overallcomplication rate was 17.5%, or 13 of 74 reconstructed breasts.

Conclusions

The use of resorbable mesh provides excellent cosmetic outcomes withminimal complications. To avoid major complications discretion should be used inpatients with risk factors such as smoking and radiation therapy.

Level of Evidence: Level IV, therapeutic study.

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Authors and Affiliations

  1. Department of Breast Surgery, Mater Misericordiae University Hospital, Dublin, Ireland

    Shiva Sharma, Mitchell Barry & Malcolm R. Kell

  2. University College Dublin, Dublin, Ireland

    Susie Van Barsel

  3. Mater Private Hospital, Dublin, Ireland

    Mitchell Barry & Malcolm R. Kell

Authors
  1. Shiva Sharma
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  2. Susie Van Barsel
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  3. Mitchell Barry
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  4. Malcolm R. Kell
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Corresponding author

Correspondence to Shiva Sharma.

Ethics declarations

Ethical standards

For this type of retrospective study formal consent from a local ethics committee is not required.

Conflict of interest

Shiva Sharma, Susie Van Barsel, Mitchell Barry, 358 Malcolm R. Kell declare that they have no conflict of interest.

Patient consent

Patients provided written consent before their inclusion in this study. Additional consent was obtained for the use of their images.

Funding

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Sharma, S., Van Barsel, S., Barry, M. et al. De novo experience of resorbable woven mesh in immediate breast reconstruction post-mastectomy. Eur J Plast Surg 40, 17–22 (2017). https://doi.org/10.1007/s00238-016-1227-1

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  • DOI: https://doi.org/10.1007/s00238-016-1227-1

Keywords

  • Breast
  • Reconstruction
  • Mesh
  • Post-mastectomy
  • Implant
  • Expander
  • Radiation
  • Brca
  • Oncology
  • Acelullar dermal matrix