PMID- 37252917
OWN - NLM
STAT- Publisher
LR  - 20230530
IS  - 1529-4242 (Electronic)
IS  - 0032-1052 (Linking)
DP  - 2023 May 26
TI  - Impact of Tissue Expander Surface Texture on Two-Stage Breast Reconstruction 
      Outcomes: A Combined Analysis of Incidence, Timing, and Severity.
LID - 10.1097/PRS.0000000000010763 [doi]
AB  - BACKGROUND: With ongoing investigations of the impact of device texturing on 
      breast implant-related anaplastic large cell lymphoma (BIA-ALCL), studies have 
      begun comparing complications profiles of tissue expanders. However, there is a 
      paucity of timing and severity data of complications. The aim of this study is to 
      provide a comparative survival analysis of post-operative complications between 
      smooth (STE) and textured tissue expanders (TTE) in breast reconstruction. 
      METHODS: A single institution experience with tissue expander breast 
      reconstruction was reviewed for complications up to 1 year post 2nd stage 
      reconstruction from 2014-2020. Demographics, comorbidities, operation-related 
      variables, and complications were evaluated. Kaplan-Meier curves, cox 
      proportional hazard models, and a consensus based ordinal logistic regression 
      model were used to compare complication profiles. RESULTS: Of 919 ttal patients, 
      65.3% (n=600) received TTEs and 34.7% (n=319) received STEs. There was increased 
      risk of infection (p<0.0001), seroma (p=0.046), expander malposition (p<0.0001), 
      and wound dehiscence (p=0.019) in STEs compared to TTEs. However, there were also 
      decreased risk of capsular contracture (p=0.005) in STEs compared to TTEs. 
      Failure of breast reconstruction (p<0.001) and wound dehiscence (p=0.018) 
      occurred significantly earlier in STEs compared to TTEs. Predictors for 
      significantly higher severity complications included: smooth tissue expander use 
      (p=0.007), shorter time to complication (p<0.0001), higher BMI (p=0.005), smoking 
      history (p=0.025), and nipple sparing mastectomy (p=0.012). CONCLUSIONS: 
      Differences in the timing and severity of complications contribute to the safety 
      profiles of tissue expanders. STEs are associated increased odds of higher 
      severity and earlier complications. Therefore, tissue expander selection may 
      depend on underlying risk factors and severity predictors.
CI  - Copyright (c) 2023 by the American Society of Plastic Surgeons.
FAU - Park, Benjamin C
AU  - Park BC
AD  - Vanderbilt University School of Medicine, Nashville, TN.
FAU - Alving-Trinh, Alexandra L
AU  - Alving-Trinh AL
AD  - Vanderbilt University School of Medicine, Nashville, TN.
FAU - Prigmore, Heather L
AU  - Prigmore HL
AD  - Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN.
FAU - Harrell, Frank E Jr
AU  - Harrell FE Jr
AD  - Vanderbilt University School of Medicine, Nashville, TN.
FAU - Sarhane, Karim
AU  - Sarhane K
AD  - Vanderbilt University Medical Center, Department of Plastic Surgery, Nashville, 
      TN.
FAU - Joseph, Jeremy T
AU  - Joseph JT
AD  - Eastern Virginia Medical School, Division of Plastic and Cosmetic Surgery, 
      Norfolk, VA.
FAU - Thomas, Harrison
AU  - Thomas H
AD  - Vanderbilt University School of Medicine, Nashville, TN.
FAU - Lupi, Alexander L
AU  - Lupi AL
AD  - Vanderbilt University School of Medicine, Nashville, TN.
FAU - Perdikis, Galen
AU  - Perdikis G
AD  - Vanderbilt University Medical Center, Department of Plastic Surgery, Nashville, 
      TN.
FAU - Higdon, Kent K
AU  - Higdon KK
AD  - Vanderbilt University Medical Center, Department of Plastic Surgery, Nashville, 
      TN.
LA  - eng
PT  - Journal Article
DEP - 20230526
PL  - United States
TA  - Plast Reconstr Surg
JT  - Plastic and reconstructive surgery
JID - 1306050
SB  - IM
COIS- Conflict of Interest Disclosure Statement: The authors declare no potential 
      conflicts of interest.
EDAT- 2023/05/30 19:16
MHDA- 2023/05/30 19:16
CRDT- 2023/05/30 13:33
PHST- 2023/05/30 19:16 [medline]
PHST- 2023/05/30 19:16 [pubmed]
PHST- 2023/05/30 13:33 [entrez]
AID - 00006534-990000000-01928 [pii]
AID - 10.1097/PRS.0000000000010763 [doi]
PST - aheadofprint
SO  - Plast Reconstr Surg. 2023 May 26. doi: 10.1097/PRS.0000000000010763.