Safety and Aesthetic Outcomes of SERASYNTH MESH BR for Direct-to-implant Breast Reconstruction: A Retrospective Single Center Analysis of 32 Consecutive Cases

Overview

Journal JPRAS Open

Specialty General Surgery

Date 2023 Sep 25

PMID 37745008

Authors

Julia Gruber

Paul Schlagnitweit

Georgios Koulaxouzidis

Affiliations

Soon will be listed here.

Abstract

Background: Bilateral mastectomy for both therapeutic and prophylactic reasons is becoming increasingly important. To achieve good results after mastectomy, synthetic meshes are often used as an alternative to acellular dermal matrices (ADMs). The aim of this study is to analyze the results of subcutaneous mastectomies and direct-to-implant breast reconstruction using SERASYNTH MESH BR.

Methods: In this work, data from mastectomies ( = 32) in 22 patients without prior radiation after breast reconstruction with SERASYNTH MESH BR from a single center were retrospectively analyzed with 1 year follow-up. Complications were categorized as serious (need for revision surgery) and minor events. Statistical analysis was performed using the -test in SPSS. Data were compared with the existing literature.

Results: Major complications occurred in 15.6% ( = 5). Two out of five revisions were due to hematoma. In three cases, a seroma followed by other complications (e.g., infections, necrosis) necessitated revision. Minor complications occurred in 12.5% of cases. Due to the safety aspect, implants were replaced in each revision. There was no significant difference in complication rates between prophylactic and therapeutic mastectomies ( = 0.3815, SE = 0.171). There was no statistically significant difference in esthetic outcomes ( = 0.3846).

Conclusion: The application of the absorbable polymer poly-p-dioxanone SERASYNTH MESH BR has complication rates comparable to those reported in the existing literature. Careful patient selection is paramount in order to limit the complication rate. SERASYNTH MESH BR can be considered a safe tool to achieve esthetic results in combination with direct-to-implant breast reconstruction.

References

Cordeiro P, Albornoz C, McCormick B, Hu Q, Van Zee K . The impact of postmastectomy radiotherapy on two-stage implant breast reconstruction: an analysis of long-term surgical outcomes, aesthetic results, and satisfaction over 13 years. Plast Reconstr Surg. 2014; 134(4):588-595. DOI: 10.1097/PRS.0000000000000523. View

Ho A, Bovill E, Macadam S, Tyldesley S, Giang J, Lennox P . Postmastectomy radiation therapy after immediate two-stage tissue expander/implant breast reconstruction: a University of British Columbia perspective. Plast Reconstr Surg. 2014; 134(1):1e-10e. DOI: 10.1097/PRS.0000000000000292. View

de Blacam C, Momoh A, Colakoglu S, Slavin S, Tobias A, Lee B . Cost analysis of implant-based breast reconstruction with acellular dermal matrix. Ann Plast Surg. 2011; 69(5):516-20. DOI: 10.1097/SAP.0b013e318217fb21. View

Spear S, Pelletiere C . Immediate breast reconstruction in two stages using textured, integrated-valve tissue expanders and breast implants. Plast Reconstr Surg. 2004; 113(7):2098-103. DOI: 10.1097/01.prs.0000122406.99750.c3. View

Dieterich M, Reimer T, Dieterich H, Stubert J, Gerber B . A short-term follow-up of implant based breast reconstruction using a titanium-coated polypropylene mesh (TiLoop(®) Bra). Eur J Surg Oncol. 2012; 38(12):1225-30. DOI: 10.1016/j.ejso.2012.08.026. View

Ricci J, Epstein S, Momoh A, Lin S, Singhal D, Lee B . A meta-analysis of implant-based breast reconstruction and timing of adjuvant radiation therapy. J Surg Res. 2017; 218:108-116. DOI: 10.1016/j.jss.2017.05.072. View

Potter S, Holcombe C, Ward J, Blazeby J . Development of a core outcome set for research and audit studies in reconstructive breast surgery. Br J Surg. 2015; 102(11):1360-71. PMC: 5034747. DOI: 10.1002/bjs.9883. View

Sbitany H, Serletti J . Acellular dermis-assisted prosthetic breast reconstruction: a systematic and critical review of efficacy and associated morbidity. Plast Reconstr Surg. 2011; 128(6):1162-1169. DOI: 10.1097/PRS.0b013e318230c29e. View

Pukancsik D, Kelemen P, Gulyas G, Ujhelyi M, Kovacs E, Eles K . Clinical experiences with the use of ULTRAPRO mesh in single-stage direct-to-implant immediate postmastectomy breast reconstruction in 102 patients: A retrospective cohort study. Eur J Surg Oncol. 2017; 43(7):1244-1251. DOI: 10.1016/j.ejso.2017.01.236. View

10.

van Bastelaar J, van Roozendaal L, Granzier R, Beets G, Vissers Y . A systematic review of flap fixation techniques in reducing seroma formation and its sequelae after mastectomy. Breast Cancer Res Treat. 2017; 167(2):409-416. DOI: 10.1007/s10549-017-4540-x. View

11.

Logan Ellis H, Asaolu O, Nebo V, Kasem A . Biological and synthetic mesh use in breast reconstructive surgery: a literature review. World J Surg Oncol. 2016; 14:121. PMC: 4839154. DOI: 10.1186/s12957-016-0874-9. View

12.

Grow J, Butterworth J, Petty P . Alternatives to Acellular Dermal Matrix: Utilization of a Gore DualMesh Sling as a Cost-Conscious Adjunct for Breast Reconstruction. Eplasty. 2017; 17:e4. PMC: 5314435. View

13.

Woodworth P, McBoyle M, Helmer S, BEAMER R . Seroma formation after breast cancer surgery: incidence and predicting factors. Am Surg. 2000; 66(5):444-50; discussion 450-1. View

14.

Spear S, Parikh P, Reisin E, Menon N . Acellular dermis-assisted breast reconstruction. Aesthetic Plast Surg. 2008; 32(3):418-25. DOI: 10.1007/s00266-008-9128-8. View

15.

Rietjens M, Garusi C, Lanfrey E, Petit J . [Cutaneous suspension: immediate breast reconstruction with abdominal cutaneous advancement using a non-resorptive mesh. Preliminary results and report of 28 cases]. Ann Chir Plast Esthet. 1997; 42(2):177-82. View

16.

Cheng A, Saint-Cyr M . Comparison of different ADM materials in breast surgery. Clin Plast Surg. 2012; 39(2):167-175. DOI: 10.1016/j.cps.2012.02.004. View

17.

Rodriguez-Unda N, Leiva S, Cheng H, Seal S, Cooney C, Rosson G . Low incidence of complications using polyglactin 910 (Vicryl) mesh in breast reconstruction: A systematic review. J Plast Reconstr Aesthet Surg. 2015; 68(11):1543-9. DOI: 10.1016/j.bjps.2015.06.018. View

18.

Bernini M, Calabrese C, Cecconi L, Santi C, Gjondedaj U, Roselli J . Subcutaneous Direct-to-Implant Breast Reconstruction: Surgical, Functional, and Aesthetic Results after Long-Term Follow-Up. Plast Reconstr Surg Glob Open. 2016; 3(12):e574. PMC: 4727683. DOI: 10.1097/GOX.0000000000000533. View

19.

Soong I, Yau T, Ho C, Lim B, Leung S, Yeung R . Post-mastectomy radiotherapy after immediate autologous breast reconstruction in primary treatment of breast cancers. Clin Oncol (R Coll Radiol). 2004; 16(4):283-9. DOI: 10.1016/j.clon.2004.01.007. View

20.

Weintraub J, Kahn D . The timing of implant exchange in the development of capsular contracture after breast reconstruction. Eplasty. 2008; 8:e31. PMC: 2424279. View