Article

Results from Over One Year of Follow-Up for Absorbable Mesh Insertion in Partial Mastectomy

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yonsei medical journal (Impact Factor: 0.77). 09/2011; 52(5):803-8. DOI: 10.3349/ymj.2011.52.5.803
Source: PubMed

ABSTRACT Recently, several clinicians have reported the advantages of simplicity and cosmetic satisfaction of absorbable mesh insertion. However, there is insufficient evidence regarding its long-term outcomes. We have investigated the surgical complications and postoperative examination from the oncologic viewpoint.
From February 2008 to March 2009, 34 breast cancer patients underwent curative surgery with absorbable mesh insertion in Samsung Medical Center. Patient characteristics and follow up results including complications, clinical and radiological findings were retrospectively investigated.
The mean age of the study population was 50.1±8.9 years old (range 31-82) with a mean tumor size of 3±1.8 cm (range 0.8-10.5), and the excised breast tissue showed a mean volume of 156.1±99.8 mL (range 27-550). Over the median follow-up period of 18±4.6 months (range 3-25), mesh associated complications, including severe pain or discomfort, edema, and recurrent fluid collection, occurred in nine patients (26.5%). In three cases (8.8%), recurrent mastitis resulted in mesh removal or surgical intervention. In the postoperative radiologic survey, the most common finding was fluid collection, which occurred in five patients (16.1%), including one case with organizing hematoma. Fat necrosis and microcalcifications were found in three patients (9.7%).
Absorbable mesh insertion has been established as a technically feasible, time-saving procedure after breast excision. However, the follow-up results showed some noticeable side effects and the oncologic safety of the procedure is unconfirmed. Therefore, we suggest that mesh insertion should be considered only in select cases and should be followed-up carefully.

0 Bookmarks
 · 
133 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Immediate mesh insertion has been recently used for breast reconstruction after breast-conserving surgery. We report a case of abscess formation following immediate nonabsorbable mesh insertion with breast-conserving surgery. In this article, we demonstrate multimodal breast imaging features and pathologic correlations of the case. In addition, we illustrate characteristic sonographic findings of nonabsorbable mesh fibers to differentiate them from a gossypiboma caused by a retained surgical sponge or tumor recurrence. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 2014
    Journal of Clinical Ultrasound 09/2014; 42(7). DOI:10.1002/jcu.22148 · 0.80 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Generally, a partial breast defect can be covered with surrounding breast tissue. However, when the tumor is located in the upper central and inner quadrant, simple closure with breast tissue is insufficient because rotation of breast tissue is difficult in this location. We introduce a surgical technique using an absorbable Interceed® pouch with double-layer skin closure for a remnant defect. A total of 43 patients with breast cancer underwent conventional breast-conserving surgery, following which an Interceed® pouch with double-layer skin closure was applied for a remnant defect of the breast. Patients assessed their own cosmetic outcomes based on a four-point scoring system. The mean age of the patients and their mean body mass index were 51.2 years and 23.1 kg/m2, respectively. Cosmetic outcomes were self-reported to be excellent in 13 cases (30.2%), good in 26 cases (60.5%), fair in three cases (7.0%), and poor in one case (2.3%). Postoperative complications occurred in two cases (4.6%). In conclusion, a use of an absorbable Interceed® pouch with double-layer skin closure is a simple, feasible, ancillary surgical technique to correct an upper central and inner quadrant breast defect without significant complications.
    The Breast Journal 05/2014; 20(4). DOI:10.1111/tbj.12281 · 1.43 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. Decellularized human skin has been used in a variety of medical applications, primarily involving soft tissue reconstruction, wound healing, and tendon augmentation. Theoretically, decellularization removes potentially immunogenic material and provides a clean scaffold for cellular and vascular in growth. The use of acellular dermal matrix in two-stage postmastectomy breast reconstruction is described. Methods. Ten consecutive breast cancer patients were treated with mastectomies and immediate reconstruction from August to November 2011. There were 8 bilateral and 1 unilateral mastectomies for a total of 17 breasts, with one exclusion for chronic tobacco use. Reconstruction included the use of a new 6 × 16 cm sterile, room temperature acellular dermal matrix patch (DermACELL) soaked in a cefazolin bath. Results. Of the 17 breasts, 15 reconstructions were completed; 14 of them with expander to implant sequence and acellular dermal matrix. Histological analysis of biopsies obtained during trimming of the matrix at the second stage appeared nonremarkable with evidence of normal healing, cellularity, and vascular infiltration. Conclusion. Postoperative observations showed that this cellular dermal matrix appears to be an appropriate adjunct to reconstruction with expanders. This acellular dermal matrix appeared to work well with all patients, even those receiving postoperative chemotherapy, postoperative radiation, prednisone, or warfarin sodium.
    01/2014; 2014:704323. DOI:10.1155/2014/704323

Full-text (3 Sources)

Download
61 Downloads
Available from
May 30, 2014