The Use of Exashapetm Bioshield Pocket in Prepectoral Breast Reconstruction: A Preliminary Experience

Abstract

Objective. In the few latter, immediate breast reconstruction, performed with prepectoral positioning of implants, is assuming an increasinglly important role in the tumor recovery process for most women. With this study we want to describe our experience in prepectoral immediate breast reconstruction using Exashape, a new pre-shaped bilayer acellular dermal matrix derived from bovine pericardium. Methods. Twenty-one patients with breast cancer were enrolled and went under momo-(5) or bilateral ( 16) nipple sparing mastectomy, for a total of 37 reconstructed breasts. All the implants have been assembled with Exashape and positioned over the pectoralis major muscle. All the patient answered to BREAST-Q questionnaire in preoperative time six months after surgery. Results. This preliminary study showed a reduction of implant's exposure time and risk of bacterial contamination, a decreased risk of injury to the implant and an easy assembly and positioning. Of Twenty-one patients enrolled for this study, only five patients had complication: four resolved after surgical revision of scars and one with implant loss. BREAST-Q resulted overall satisfaction with breasts, psychosocial well-being, and sexual well-being were all significantly increased (p < 0.05) and chest discomfort got significantly worse (p < 0.05). Conclusions. Although further studies would be useful to validate our result. We can say that Exashape TM has proved to be useful in breast reconstruction, allowing a good aesthetic and functional result.

BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations

“…As stated previously, genetic predisposition and chronic inflammation seem to be potential driving factors promoting T cell proliferation and mutation, eventually leading to lymphomagenesis [26]. The inflammation causing chronic antigenic stimulation might have different underlying triggers, among which bacterial contamination, shell shedding of particulates, shell surface friction, acellular matrices, and reactive components have been hypothesized [27][28][29][30][31]. Many emerging theories on BIA-ALCL pathogenesis are subjects of discussion and investigation.…”

“…Axillary lymphadenopathy, on the other hand, might be an indicator of early disease. Less frequently, BIA-ALCL might be associated with Baker IV-type capsular contracture with deformation of the breast profile and skin erythema or ulceration [30,52]. The average age at diagnosis for BIA-ALCL is around 54 years, with symptoms appearing at about 7-10 years after implantation [52].…”

Shoulder Function Assessment After Fald Flap Breast Reconstruction: Comparing Ultrasound Results and Patients’ Self Perception

“…The DIEP flap is currently the favoured method in a broad spectrum of patients due to similarity between abdominal and breast subcutaneous tissue in terms of shape, consistency, and low donor site morbidity [1][2][3] . Nevertheless, there do exist more reconstructive options which are indicated to patients with high-risk comorbidities 4 , contraindications to microsurgery 5,6 , and either insufficient or inappropriate abdominal tissue for DIEP flap 7 . FALD flap represents a suitable alternative in such cases as, being a myocutaneous flap 8 , it offers a huge availability of soft tissues and gives the plastic surgeon the possibility of a total autologous reconstruction of small to moderate sized breasts without implants [9][10][11][12][13] .…”

Pressure Ulcers Incidence in a Perioperative Neurosurgical Setting

“…Pressure ulcer development is a major burden in surgical patients, increasing the length of hospital stay and the healing process, possibly leading to infectious complications and higher health care costs 1,2 . Despite the continuous release of novel matrices and products stimulating tissue regeneration and despite progress made in the field reconstructive surgery thus far, medical and conventional surgical strategies for loss of substance lesions present limits when it comes to complex tissue defects requiring fine reconstruction and generate large part of pathology associated high morbidities and costs [3][4][5][6][7][8] . Pressure ulcers are recognized as an unfavorable prognostic factor that is associated with increasing morbidity and mortality [9][10][11] .…”