Handchir Mikrochir Plast Chir 2022; 54(04): 269-278
DOI: 10.1055/a-1830-8217
Übersichtsarbeit

Der Stellenwert von synthetischen Netzen und biologischen Matrices in der Implantat-basierten Brustrekonstruktion

The Value of Synthetic and Biologic Meshes in Implant-Based Breast Reconstruction
1   Institut für Klinisch-Experimentelle Chirurgie, Universität des Saarlandes, Homburg/Saar, Deutschland
,
Daniel Schmauss
2   Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Ospedale Regionale di Lugano (ORL), Ente Ospedaliero Cantonale (EOC), Lugano, Schweiz
3   Fakultät der Biomedizinischen Wissenschaften, Università della Svizzera Italiana, Lugano, Schweiz
,
Yves Harder
2   Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Ospedale Regionale di Lugano (ORL), Ente Ospedaliero Cantonale (EOC), Lugano, Schweiz
3   Fakultät der Biomedizinischen Wissenschaften, Università della Svizzera Italiana, Lugano, Schweiz
› Author Affiliations

Zusammenfassung

Die Implantat-basierte Brustrekonstruktion (IBBR) entwickelt sich stetig weiter und hat insbesondere durch den steigenden Einsatz synthetischer Netze und biologischer Matrices in den letzten Jahren neue Impulse bekommen. Der Einsatz solcher Netze und Matrices in der subpektoralen und präpektoralen IBBR hat durch eine verbesserte Platzierung und Weichteildeckung der verwendeten Implantate zu niedrigeren Komplikationsraten und guten ästhetischen Ergebnissen geführt. Inzwischen hat eine große Zahl verschiedener biologischer Matrices und synthetischer Netze Eingang in die klinische Nutzung gefunden, die sich in Material, Prozessierung, Größe und Kosten unterscheiden. Ziel dieser Übersichtsarbeit ist es, diese Netze in den Kontext der rekonstruktiven Brustchirurgie einzuordnen und einen Überblick über die Vor- und Nachteile bei deren Einsatz zu geben.

Abstract

Implant based breast reconstruction (IBBR) keeps evolving and has been influenced heavily by the use of synthetic and biologic meshes in the last years. In both, subpectoral as well as prepectoral approaches the use of synthetic and biologic meshes has made it possible to place implants precisely according to the breast’s footprint and strengthen soft-tissue coverage, particularly in the lower pole of the breast with lower complication rates and better cosmesis. Various mesh options that differ in material, processing, size and cost are currently in clinical use. This review aims to define the role of biologic and synthetic meshes in IBBR regarding the advantages and disadvantages of their use.



Publication History

Received: 06 December 2021

Accepted: 05 April 2022

Article published online:
09 August 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Snyderman RK, Guthrie RH. Reconstruction of the female breast following radical mastectomy. Plastic and Reconstructive Surgery 1971; 47: 565-567 DOI: 10.1097/00006534-197106000-00008.
  • 2 Blanckaert M, Vranckx J. Oncological safety of therapeutic ‘nipple-sparing mastectomy’ followed by reconstruction: a systematic review. Acta Chirurgica Belgica 2021; 121: 155-163
  • 3 Finlay B, Kollias V, Hall KA. et al. Long-term outcomes of breast reconstruction and the need for revision surgery. ANZ Journal of Surgery 2021; 91: 1751-1758 DOI: 10.1111/ans.17118.
  • 4 Panchal H, Matros E. Current trends in postmastectomy breast reconstruction. Plastic and Reconstructive Surgery 2017; 140: 7S-13S DOI: 10.1097/PRS.0000000000003941.
  • 5 Bertozzi N, Pesce M, Santi P. et al. One-Stage Immediate Breast Reconstruction: A Concise Review. BioMed Research International 2017; 2017: 6486859
  • 6 Govrin-Yehudain J, Dvir H, Preise D. et al. Lightweight breast implants: A novel solution for breast augmentation and reconstruction mammaplasty. Aesthetic Surgery Journal 2015; 35: 965-971 DOI: 10.1093/asj/sjv080.
  • 7 Fischer JP, Wes AM, Tuggle CT. et al. Risk analysis and stratification of surgical morbidity after immediate breast reconstruction. J Am Coll Surg 2013; 217: 780-787 DOI: 10.1016/j.jamcollsurg.2013.07.004.
  • 8 Groth AK, Graf R. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and the Textured Breast Implant Crisis. Aesthetic Plastic Surgery 2020; 44: 1951 DOI: 10.1007/s00266-019-01521-3.
  • 9 Margulies IG, Salzberg CA. The use of acellular dermal matrix in breast reconstruction: Evolution of techniques over 2 decades. Gland Surgery 2019; 8: 3-10
  • 10 Scheflan M, Colwell AS. Tissue reinforcement in implant-based breast reconstruction. Plastic and Reconstructive Surgery 2014; 2: e192 DOI: 10.1097/GOX.0000000000000140.
  • 11 Weinzierl A, Schmauss D, Brucato D. et al. Implant-Based Breast Reconstruction after Mastectomy, from the Subpectoral to the Prepectoral Approach: An Evidence-Based Change of Mind?. Journal of Clinical Medicine 2022; 11: 3079 DOI: 10.3390/jcm11113079.
  • 12 Sigalove S, Maxwell GP, Sigalove NM. et al. Prepectoral Implant-Based Breast Reconstruction: Rationale, Indications, and Preliminary Results. Plastic and Reconstructive Surgery 2017; 139: 158-173 DOI: 10.1097/PRS.0000000000002950.
  • 13 Cabalag MS, Rostek M, Miller GS. et al. Alloplastic adjuncts in breast reconstruction. Gland Surgery 2016; 5: 30S-43S
  • 14 Rolph R, Farhadi J. The use of meshes and matrices in breast reconstruction. Br J Hosp Med (Lond) 2018; 79: 454-459 DOI: 10.12968/hmed.2018.79.8.454.
  • 15 Kim JYS, Mlodinow AS. What’s new in acellular dermal matrix and soft-tissue support for prosthetic breast reconstruction. Plastic and Reconstructive Surgery 2017; 140: 647-653
  • 16 Ranganathan K, Santosa KB, Lyons DA. et al. Use of acellular dermal matrix in postmastectomy breast reconstruction: Are all Acellular dermal matrices created equal?. Plastic and Reconstructive Surgery 2015; 136: 19-26 DOI: 10.1097/PRS.0000000000001569.
  • 17 Greig H, Roller J, Ziaziaris W. et al. A retrospective review of breast reconstruction outcomes comparing AlloDerm and DermaCELL. JPRAS Open 2019; 22: e1209 DOI: 10.1016/j.jpra.2019.07.005.
  • 18 Mendenhall S, Anderson L, Ying J. et al. The BREASTrial Stage II: ADM Breast Reconstruction Outcomes from Definitive Reconstruction to 3 Months Postoperative. Plast Reconstr Surg Glob Open 2017; 5: 1076-1082 DOI: 10.1097/GOX.0000000000001209.
  • 19 Ball JF, Sheena Y, Tarek Saleh DM. et al. A direct comparison of porcine (Strattice) and bovine (Surgimend) acellular dermal matrices in implant-based immediate breast reconstruction. Journal of Plastic, Reconstructive and Aesthetic Surgery 2017; 70: 283-293 DOI: 10.1016/j.bjps.2017.05.015.
  • 20 Mazari FAK, Wattoo GM, Kazzazi NH. et al. The comparison of strattice and surgi mend in acellular dermal matrix-assisted, implant-based immediate breast reconstruction. Plastic and Reconstructive Surgery 2018; 141: 283-293 DOI: 10.1097/PRS.0000000000004018.
  • 21 https://www.fda.gov/medical-devices/safety-communications/acellular-dermal-matrix-adm-products-used-implant-based-breast-reconstruction-differ-complication
  • 22 Ozel L, Kara VM, Sunamak O. et al. Skin–Areola, Nipple Sparing, and Subcutaneous Mastectomy and Immediate Implant-Based Breast Reconstruction Using a Titanium-Coated Polypropylene Mesh. Journal of Breast Health 2015; 11: 141-143 DOI: 10.5152/tjbh.2015.2315.
  • 23 Tessler O, Reish RG, Maman DY. et al. Beyond biologics: Absorbable mesh as a low-cost, low-complication sling for implant-based breast reconstruction. Plastic and Reconstructive Surgery 2014; 133: 90e-90e DOI: 10.1097/01.prs.0000437253.55457.63.
  • 24 Rolph RC, Macmillan RD, Nestle-Kraemling C. et al. Delayed erythematous skin reaction with SERI(R)-assisted direct to implant breast reconstruction. Journal of Plastic, Reconstructive and Aesthetic Surgery 2018; 71: 29-31
  • 25 Dieterich M, Paepke S, Zwiefel K. et al. Implant-based breast reconstruction using a titanium-coated polypropylene mesh (TiLOOP Bra): A multicenter study of 231 cases. Plastic and Reconstructive Surgery 2013; 132: 8e-19e DOI: 10.1097/PRS.0b013e318290f8a0.
  • 26 Haynes DF, Kreithen JC. Vicryl mesh in expander/implant breast reconstruction: Long-Term Follow-Up in 38 patients. Plastic and Reconstructive Surgery 2014; 134: 892-899 doi: 10.1097/PRS.0000000000000610
  • 27 Gschwantler-Kaulich D, Schrenk P, Bjelic-Radisic V. et al. Mesh versus acellular dermal matrix in immediate implant-based breast reconstruction - A prospective randomized trial. European Journal of Surgical Oncology 2016; 42: 665-671 DOI: 10.1016/j.ejso.2016.02.007.
  • 28 Gschwantler-Kaulich D, Schrenk P, Bjelic-Radisic V. et al. Corrigendum to “Mesh versus acellular dermal matrix in immediate implant-based breast reconstruction – A prospective randomized trial” [Eur J Surg Oncol 42 (5) (2016) 665–671] (S0748798316001013) (10.1016/j.ejso.2016.02.007)). European Journal of Surgical Oncology 2017; 43: 1380-1381. doi: 10.1016/j.ejso.2017.05.001
  • 29 Schüler K, Paepke S, Kohlmann T. et al. Postoperative Complications in Breast Reconstruction With Porcine Acellular Dermis and Polypropylene Meshes in Subpectoral Implant Placement. In Vivo 2021; 35: 2739-2746 DOI: 10.21873/invivo.12558.
  • 30 Eichler C, Schulz C, Thangarajah F. et al. A retrospective head-to-head comparison between TiLoop Bra/TiMesh and Seragyn in 320 cases of reconstructive breast surgery. Anticancer Research 2019; 39: 2599-2605 DOI: 10.21873/anticanres.13383.
  • 31 Ho TB, Wood WC, Mspt PDS. Breast Reconstruction in the Setting of Postmastectomy Radiotherapy: Controversies and Disparities. Oncology (Williston Park) 2019; 33: 688845
  • 32 Hille-Betz U, Kniebusch N, Wojcinski S. et al. Breast Reconstruction and Revision Surgery for Implant-associated Breast Deformities Using Porcine Acellular Dermal Matrix: A Multicenter Study of 156 Cases. Annals of Surgical Oncology 2015; 22: 1146-1152 DOI: 10.1245/s10434-014-4098-3.
  • 33 Salzberg CA, Dunavant C, Nocera N. Immediate breast reconstruction using porcine acellular dermal matrix (Strattice): Long-term outcomes and complications. Journal of Plastic, Reconstructive and Aesthetic Surgery 2013; 66: 323-328 DOI: 10.1016/j.bjps.2012.10.015.
  • 34 Ng CE, Pieri A, Fasih T. Porcine acellular dermis-based breast reconstruction: complications and outcomes following adjuvant radiotherapy. European Journal of Plastic Surgery 2015; 38: 459-462 DOI: 10.1007/s00238-015-1130-1.
  • 35 Moyer HR, Pinell-White X, Losken A. The effect of radiation on acellular dermal matrix and capsule formation in breast reconstruction: Clinical outcomes and histologic analysis. Plastic and Reconstructive Surgery 2014; 133: 214-221 DOI: 10.1097/01.prs.0000437255.01199.42.
  • 36 Seth AK, Hirsch EM, Fine NA. et al. Utility of acellular dermis-assisted breast reconstruction in the setting of radiation: A comparative analysis. Plastic and Reconstructive Surgery 2012; 130: 750-758 DOI: 10.1097/PRS.0b013e318262f009.
  • 37 Chopra K, Buckingham B, Matthews J. et al. Acellular dermal matrix reduces capsule formation in two-stage breast reconstruction. International Wound Journal 2017; 14: 414-419 DOI: 10.1111/iwj.12620.
  • 38 Liu J, Hou J, Li Z. et al. Efficacy of Acellular Dermal Matrix in Capsular Contracture of Implant-Based Breast Reconstruction: A Single-Arm Meta-analysis. Aesthetic Plastic Surgery 2020; 44: 735-742 DOI: 10.1007/s00266-019-01603-2.
  • 39 Lardi AM, Ho-Asjoe M, Junge K. et al. Capsular contracture in implant based breast reconstruction-the effect of porcine acellular dermal matrix. Gland Surgery 2017; 6: 49-56 DOI: 10.21037/gs.2017.01.02.
  • 40 Nahabedian MY. Prosthetic Breast Reconstruction and Red Breast Syndrome: Demystification and a Review of the Literature. Plastic and Reconstructive Surgery - Global Open 2019; 7: e2108 DOI: 10.1097/gox.0000000000002108.
  • 41 Pittman TA, Fan KL, Knapp A. et al. Comparison of Different Acellular Dermal Matrices in Breast Reconstruction: The 50/50 Study. Plastic and Reconstructive Surgery 2017; 139: 521-528
  • 42 Mayer HF, Perez Colman MC, Stoppani I. Red breast syndrome (RBS) associated to the use of polyglycolic mesh in breast reconstruction: A case report. Acta Chirurgiae Plasticae 2020; 62: 50-52
  • 43 Lohmander F, Lagergren J, Johansson H. et al. Effect of immediate implant-based breast reconstruction after mastectomy with and without acellular dermal matrix among women with breast cancer: A randomized clinical trial. JAMA Network Open 2021; 4: e2127806 DOI: 10.1001/jamanetworkopen.2021.27806.
  • 44 Potter S, Browning D, Savovic J. et al. Systematic review and critical appraisal of the impact of acellular dermal matrix use on the outcomes of implant-based breast reconstruction. British Journal of Surgery 2015; 102: 1010-1025
  • 45 Lohmander F, Lagergren J, Roy PG. et al. Implant Based Breast Reconstruction with Acellular Dermal Matrix: Safety Data from an Open-label, Multicenter, Randomized, Controlled Trial in the Setting of Breast Cancer Treatment. Annals of Surgery 2019; 269: 836-841 DOI: 10.1097/SLA.0000000000003054.
  • 46 Karp NS, Salibian AA. Splitting the Difference: Using Synthetic and Biologic Mesh to Decrease Cost in Prepectoral Immediate Implant Breast Reconstruction. Plastic and Reconstructive Surgery 2021; 147: 580-584 DOI: 10.1097/PRS.0000000000007638.
  • 47 Lardi AM, Ho-Asjoe M, Mohanna PN. et al. Immediate breast reconstruction with acellular dermal matrix: Factors affecting outcome. Journal of Plastic, Reconstructive and Aesthetic Surgery 2014; 67: 1098-105 DOI: 10.1016/j.bjps.2014.05.020.
  • 48 Rose JF, Zafar SN, Ellsworth WA.. Does Acellular Dermal Matrix Thickness Affect Complication Rate in Tissue Expander Based Breast Reconstruction?. Plastic Surgery International 2016; 2016: 2867097 DOI: 10.1155/2016/2867097.
  • 49 Garcia O, Scott JR. Analysis of acellular dermal matrix integration and revascularization following tissue expander breast reconstruction in a clinically relevant large-animal model. Plastic and Reconstructive Surgery 2013; 131: 741e-751e DOI: 10.1097/PRS.0b013e3182865c6d.
  • 50 Scheflan M, Allweis TM, ben Yehuda D. et al. Meshed Acellular Dermal Matrix in Immediate Prepectoral Implant-based Breast Reconstruction. Plastic and Reconstructive Surgery - Global Open 2020; 8: e3265 DOI: 10.1097/GOX.0000000000003265.
  • 51 Sweitzer K, Carruthers KH, Blume L. et al. The Biomechanical Properties of Meshed versus Perforated Acellular Dermal Matrices (ADMs). Plastic and Reconstructive Surgery – Global Open 2021; 9: e3454 DOI: 10.1097/GOX.0000000000003454.
  • 52 Cogliandro A, Barone M, Tenna S. et al. The Role of Lipofilling After Breast Reconstruction: Evaluation of Outcomes and Patient Satisfaction with BREAST-Q. Aesthetic Plastic Surgery 2017; 41: 1325-1331 DOI: 10.1007/s00266-017-0912-1.
  • 53 Brown AWW, Kabir M, Sherman KA. et al. Patient reported outcomes of autologous fat grafting after breast cancer surgery. Breast 2017; 35: 14-20 DOI: 10.1016/j.breast.2017.06.006.
  • 54 Fabiocchi L, Semprini G, Cattin F. et al. ‘Reverse expansion’: A new technique of breast reconstruction with autologous tissue. Journal of Plastic, Reconstructive and Aesthetic Surgery 2017; 70: 1537-1542 DOI: 10.1016/j.bjps.2017.07.001.
  • 55 Stillaert FBJL, Lannau B, Van Landuyt K. et al. The Prepectoral, Hybrid Breast Reconstruction: The Synergy of Lipofilling and Breast Implants. Plastic and Reconstructive Surgery - Global Open 2020; 8: e2966 DOI: 10.1097/GOX.0000000000002966.
  • 56 Lauritzen E, Damsgaard TE. Use of Indocyanine Green Angiography decreases the risk of complications in autologous- and implant-based breast reconstruction: A systematic review and meta-analysis. Journal of Plastic, Reconstructive and Aesthetic Surgery 2021; 74: 1703-1717 10.1016/j.bjps.2021.03.034
  • 57 Mehta S, Rolph R, Cornelius V. et al. Local heat preconditioning in skin sparing mastectomy: A pilot study. Journal of Plastic, Reconstructive and Aesthetic Surgery 2013; 66: 1676-1682 DOI: 10.1016/j.bjps.2013.07.034.
  • 58 Singla A, Singla A, Lai E. et al. Subcutaneously Placed Breast Implants after a Skin-Sparing Mastectomy: Do We Always Need ADM?. Plastic and Reconstructive Surgery - Global Open 2017; 5: e1371 DOI: 10.1097/GOX.0000000000001371.
  • 59 Frey JD, Salibian AA, Choi M. et al. Mastectomy Flap Thickness and Complications in Nipple-Sparing Mastectomy: Objective Evaluation using Magnetic Resonance Imaging. Plastic and Reconstructive Surgery - Global Open 2017; 5: e1439 DOI: 10.1097/GOX.0000000000001439.
  • 59 Momeni A, Kanchwala S, Sbitany H. Oncoplastic Procedures in Preparation for Nipple-Sparing Mastectomy and Autologous Breast Reconstruction: Controlling the Breast Envelope. Plastic and Reconstructive Surgery 2020; 145: 914-920 DOI: 10.1097/PRS.0000000000006657.