Use of a long term complete resorbable synthetic mesh in pre-pectoral implant-based breast reconstruction - results from the learning curve period
Paepke S.1, Klein E.1, Dittmer S.2, Kiechle M.1
1Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland, 2Brustzentrum am Englischen Garten, München, Deutschland
Zielsetzung: The variability of different ADMs or synthetic meshes (non-, partial-, short- and long-term-resorbable) adds a new dimension of clinical research in breast reconstruction especially in patients with smooth implants. TIGRŪ-Matrix is a long term (approx. 36 months) complete resorbable mesh with anticipated benefits in short term e.g. implant stabilization and long-term follow up e.g. capsular contraction.
Materialien und Methoden: A retrospective clinical-report-based documentation was done. Data analysis of our pre-defined learning curve focused on patient demographics, indication, feasibility; specific surgical techniques and short term cosmetic outcome were analyzed.
Ergebnisse: From 08/2018 until 12/2019 36 Patients (median age 23-81) were analyzed. Primary operations as well as after primary systemic therapy with implant or expander independent on BMI; immediate or delayed reconstruction were performed. Shaping TIGRŪ individually into 4 different sling or pocket forms was established. Our preferences are sling techniques and individual intraoperative pocket-form, letter especially for smooth implants.
Cosmetic outcome was rated in > 85% as very satisfied; tissue integration, low seroma volume, days with drains between 2,5 - 4 were reported. Handling and feasibility of TIGRŪ-Matrix + smooth implants in pre-pectoral implant position was easy and sufficient. A reconstructive failure occurs because of involved margins (2), wound infection (2) and wound dehiscence (1).
Zusammenfassung: Use of TIGRŪ-Matrix enables an additional opportunity for pre-pectoral reconstructive techniques especially in combination with smooth implants; preserving the natural anatomy and lowers the risk of BIA-LCAL.
A prospective international multicenter AWOgyn-sponsored trial is initiated Q1/2020 to demonstrate patient reported outcome and safety parameters.