Background: The last two decades have seen significant changes in surgical management of breast cancer.The offer of immediate breast reconstruction (IBR) following mastectomy is currently standard practice.Skin sparing and nipple sparing mastectomy with implant-based IBR have emerged as oncologically safe treatment options. Prepectoral implant placement and complete coverage of implant with acellular dermal matrix (ADM) eliminates the need to detach the muscle from underlying chest wall in contrast to the subpectoral technique. We report short-term outcomes of a multicentre study from the United Kingdom (UK) using Braxon ® in women having an IBR. The inpatient hospital stay was 1.48 days. About 23% of patients had a seroma, 30% had erythema requiring antibiotics and the explant rate was 10.2 percent. Bilateral reconstructions were significantly associated with implant loss and peri-operative complications on univariate analysis.Conclusions: Our early experience with this novel prepectoral technique using Braxon ® has shown it to be an effective technique with complication rates comparable to subpectoral IBR. The advantages of prepectoral implant-based IBR are quicker postoperative recovery and short post-operative hospital stay.Long-term studies are required to assess rippling, post-operative animation, capsular contracture and impact of radiotherapy.
Diameter is a poor predictor of FDU of AVF. Arterial diameter measurements add no diagnostic value for BCAVF. Poor specificity suggests a diameter under 2 mm at the wrist should not preclude AVF formation. Vascular kidney disease is an independent negative predictor for FDU in all AVF.
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