A Comparative Analysis of Tissue Expander Reconstruction of Burned and Unburned Chest and Breasts Using Endoscopic and Open Techniques
A Comparative Analysis of Tissue Expander Reconstruction of Burned and Unburned Chest and Breasts Using Endoscopic and Open Techniques
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DOI：
10.1097/prs.0b013e3181c91d27
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发表时间：
2010-02-01
影响因子：
3.6
通讯作者：
Cederna, Paul S.
中科院分区：
文献类型：
--
作者：
Levi, Benjamin;Brown, David L.;Cederna, Paul S.
背景资料：由于担心受损皮肤的伸展能力而不会出现并发症，组织扩张术并没有被广泛接受用于乳房和胸部烧伤畸形的重建。作者假设，组织扩张器重建乳房和胸部烧伤畸形是可靠的，其结局与扩张类似的非烧伤组织相似。作者使用先天性乳房异常作为对照，因为它们具有相似的重建挑战：收缩的皮肤包膜和实质和乳头乳晕复合体的严重畸形。作者还假设，内窥镜技术可能会改善乳腺和胸部烧伤reconstruction.Methods的结果：一项回顾性研究完成了组织扩张器重建烧伤和先天性乳房畸形。所有重建均使用内窥镜或开放式组织扩张器放置以及随后的局部组织重排。数据进行了分析，使用参数和非参数的methods.Results：重建烧伤畸形，15名妇女有37个扩张器放置。在先天性乳房队列中，20例患者放置了22个组织扩张器。烧伤和先天性患者之间的随访时间、体重指数或合并症无统计学差异。两组之间的重大并发症无统计学差异（p = 0.72）。在烧伤畸形队列中，内窥镜重建术的主要并发症较少（p = 0.04），每个扩张器所需的手术时间较少（p < 0.001），扩张所需的时间较少（p = 0.021）。结论：作者认为，乳房和胸部烧伤畸形可以安全地用组织扩张器重建，而不会增加先天性乳房扩张器重建术的并发症。此外，内窥镜技术对于烧伤畸形可能是上级的，因为改进了可视化和远程切口。（Plast。重建125：547，2010）。
Background: Tissue expansion is not widely accepted for reconstruction of breast and chest burn deformities because of concerns about the capacity of compromised skin to stretch without complications. The authors hypothesized that tissue expander reconstruction of breast and chest burn deformities is reliable and has outcomes similar to those of expansion of similar nonburned tissues. The authors used congenital breast anomalies as a control because they share similar reconstructive challenges: constricted skin envelope and gross malformation of the parenchyma and nipple-areola complex. The authors also hypothesized that endoscopic techniques may improve outcomes for breast and chest burn reconstruction.Methods: A retrospective review was completed of tissue expander reconstructions of burn and congenital breast deformities. All reconstructions used an endoscopic or open tissue expander placement and subsequent local tissue rearrangements. Data were analyzed using parametric and nonparametric methods.Results: For reconstruction of burn deformities, 15 women had 37 expanders placed. Within the congenital breast cohort, 20 patients had 22 tissue expanders placed. There were no statistical differences in follow-up time, body mass index, or comorbidities between burn and congenital patients. There was no statistical difference in major complications (p = 0.72) between these groups. Within the burn deformity cohort, endoscopic reconstructions had fewer major complications (p = 0.04), required less operative time per expander (p < 0.001), and required less time to expand (p = 0.021).Conclusions: The authors believe that breast and chest burn deformities can be safely reconstructed with tissue expanders without increased complications over expander reconstruction of the congenital breast. Furthermore, endoscopic techniques may be superior for burn deformities because of improved visualization and remote incisions. (Plast. Reconstr. Surg. 125: 547, 2010.)