异体脱细胞真皮在聚丙烯酰胺水凝胶取出术后乳房假体覆盖缺损修复中的应用

目的 乳房内聚丙烯酰胺水凝胶因并发症取出后,在进行假体置入时,由于局部组织的缺损会导致乳房假体覆盖不全,探讨采用异体脱细胞真皮修复聚丙烯酰胺水凝胶取出术乳房局部缺损的效果.方法 对46例患者进行乳房内聚丙烯水凝胶取出术后乳房形态的修复,在采用假体置入的同时,以异体脱细胞真皮修复乳房覆盖假体的局部缺损.置入乳房假体后,将脱细胞真皮在保持一定的张力时缝合固定于周围组织.结果 术后随访6个月至2年,患者乳房形态都获得了很好的修复,无假体疝出及包膜挛缩的发生.术后13个月病理检查显示,置入的脱细胞真皮与周围组织融合良好.结论 通过采用异体脱细胞真皮修复缺损的腺体或肌肉,虽然不能明显增加皮下组织的厚度,但是能够保持假体周围张力的连续性,避免因为局部张力的突然减少而产生假体膨出,是值得推荐的一种局部乳房缺损的修复方法.

Correction of regional defects in the breast with acellular allogeneic dermis after removal of polyacrylamide hydrogel

Objective When implantation of a prosthesis is performed for patients with a local defect of the breast after the removal of polyacrylamide hydrogel,incomplete coverage of the surface of the prosthesis occurs in these cases.The aim of this study was to explore the effectiveness of acellular allogeneic dermis in the repair of defects after prosthesis implantation.Methods Breast prosthesis implantation together with acellular allogeneic dermis repair was performed in 46 cases.Acellular allogeneic dermis was applied to cover the surface of the prosthesis,and interrupted suture was used between the margin of the dermis and the incisional margin of the gland,while appropriate tension was maintained.Results There were no complications occurred postoperatively.Correction of local depression in the breast was excellent in all cases.Histological examination showed the implanted acellular allogeneic dermis was integrated into the peripheral tissue.Conclusions Acellular allogeneic dermis can be used for repairing breast and muscle defects,in order to cover the prosthesis.Although it cannot significantly increase the thickness of the subcutaneous tissue,it can maintain the integrity of the peripheral tension around the prosthesis.In this way,it can avoid bulging of the prosthesis caused by a sudden reduction of local tension.Moreover,donor site injury is avoided.Acellular allogeneic dermis is an effective method for the repair of local breast defects.