脱细胞异体真皮联合硅凝胶假体植入矫正乳房术后继发畸形

doi:10.3877/cma.j.issn.1674-0807.2011.02.004

目的

探讨利用脱细胞异体真皮联合硅凝胶假体植入矫正乳房因聚丙烯酰胺水凝胶取出术造成的继发畸形,并对其早期临床效果做出评价。

方法

2008年1月至2010年5月期间,共有10 例注射式隆乳术后患者在本院进行了脱细胞异体真皮联合硅凝胶假体植入术。脱细胞异体真皮被用于修补和填充胸大肌及乳腺腺体组织缺损,包裹硅凝胶假体的下1/3,以重建乳房下皱襞。

结果

术后随访12 个月,乳房外形满意,无感染、积液等并发症。

结论

应用脱细胞异体真皮联合硅凝胶假体植入可避免取出乳房内聚丙烯酰胺水凝胶后造成的严重乳房畸形。在严格把握适应证的前提下,可以取得较好的临床效果。

关键词: 乳房整形, 脱细胞异体真皮, 聚丙烯酰胺水凝胶, 隆乳术, 硅凝胶假体植入

Objective

To evaluate the early clinical outcome and efficacy of combination of acellular allogenic dermal matrix with silicone gel implant to correct secondary deformities following removal of polyacrylamide hydrogel (PAHG) for breast augmentation.

Methods

A total of 10 patients (20 breasts) who had had breast augmentation by PAHG injection were admitted in our hospital from January 2008 to May 2010. The injected PAHG was removed,then the silicone gel implant was placed for breast reconstruction,the acellular allogenic dermal matrix was inserted to replenish the insufficient pectoralis major muscle and mammary tissue,and the inframammary fold was created by encapsulation of the lower third of the implant.

Results

The follow-up of 12 months showed all the 10 patients were satisfied with the breast appearance and no infection,seroma,implant malposition or other complications happened.

Conclusions

Acellular allogenic dermal matrix combined with silicone gel implant can avoid severe breast deformity from removal of injected PAHG. Ideal outcome can be achieved with stringent adherence to the indications for this procedure.

Key words: mamoplasty, acellular allogenic dermis, polyacrylamide hydrogel, breast augmentation, silicone gel implant

图1 同期行脱细胞异体真皮联合硅凝胶假体植入隆乳术本例采用乳房下皱襞切口,图中显示将脱细胞异体真皮覆盖假体下缘并固定于乳房下皱襞。

图2 二期行脱细胞异体真皮联合硅凝胶假体植入隆乳术术中应用脱细胞异体真皮包裹硅凝胶假体。

图3 同期脱细胞异体真皮联合硅凝胶假体植入隆乳术前后乳房外观比较术前:a 正位、b 右斜位、c 右侧位、d 左斜位、e 左侧位;术后3月:f 正位、g 右斜位、h 右侧位、i 左斜位、j 左侧位

图4 二期脱细胞异体真皮联合硅凝胶假体植入隆乳术前后乳房外观比较术前:a 正位、b 右斜位、c 右侧位、d 左斜位、e 左侧位;术后1年:f 正位、g 右斜位、h 右侧位、i 左斜位、j 左侧位

[1]	孙家明,张勇,王介聪,等. 聚丙烯酰胺水凝胶注射隆乳取除术157 例分析[J]. 中华医学美学美容杂志,2009,15(2):88-91.
[2]	Antony AK,McCarthy CM,Cordeiro PG,et al. Acellular human dermis implantation in 153 immediate two-stage tissue expander breast reconstructions: determining the incidence and significant predictors of complications[J]. Plast Reconstr Surg,2010,125(6):1606-1614.
[3]	方彰林.乳房美容整形外科手术学[M].北京:北京出版社,1994:14-21.
[4]	乔群,孙家明.乳房整形美容外科学[M].郑州:郑州大学出版社,2004:269-272.
[5]	林红,施莹莹,黄玲,等.聚丙烯酰胺水凝胶注射式隆乳术后并发症的处理[J].中华乳腺病杂志:电子版,2008,2(3):336-338.
[6]	Qiao Q,Wang X,Sun J,et al. Management for postoperative complications of breast augmentation by injected polyacrylamide hydrogel[J]. Aesthetic Plast Surg,2005,29(3):156-161.
[7]	穆大力,栾杰,穆兰花,等.聚丙烯酰胺水凝胶取出术后乳房形态的修复[J].中华医学美学美容杂志,2009,15(2):80-83.
[8]	黎宁,李峰,池刚毅,等.乳房内少量聚丙烯酰胺凝胶残留对同期假体植入的影响[J].中国组织工程研究与临床康复,2009,13(34):6693-6696.
[9]	霍孟华,戚可名,黄金井,等.异体脱细胞真皮基质的研究与应用[J].中华整形外科杂志,2002,18(5):311-313.
[10]	Baxter RA. Intracapsular allogenic dermal grafts for breast implant-related problems[J]. Plast Reconstr Surg,2003,112(6):1692-1696.
[11]	曾昂,乔群,张海林,等. 乳房假体植入术后乳房下皱襞低的原因分析及处理[J]. 中国美容医学,2008,17(5):623-624.
[12]	李海宁,王春仁,曹红英,等.T-1 型脱细胞异体组织补片生物相容性评价研究[J].中国医疗器械杂志,2004,28(2):117-119,132.
[13]	Nguyen MD,Chen C,Colakoglu S,et al. Infectious complications leading to explantation in implant-based breast reconstruction with AlloDerm[J]. Eplasty,2010,10:e48.
[14]	Chun YS,Verma K,Rosen H,et al. Implant-based breast reconstruction using acellular dermal matrix and the risk of postoperative complications[J]. Plast Reconstr Surg,2010,125(2):429-36.
[15]	Stump A,3rd HLH,Connor J,et al. The use of acellular dermal matrix to prevent capsule formation around implants in a primate model[J]. Plast Reconstr Surg,2009,124(1):82-91.

[1]	于梦溪, 金洪娟, 袁久莉, 邵英, 刘海鹏, 张舵. 奥美定隆胸术后哺乳期乳房肿大一例[J/OL]. 中华乳腺病杂志(电子版), 2013, 07(03): 230-232.
[2]	艾小红, 明佳, 范林军. 腔镜下隆乳剂取出术后反复感染治疗的个案报道[J/OL]. 中华乳腺病杂志(电子版), 2011, 05(04): 503-507.
[3]	张海林, 王阳, 白明, 曾昂, 李仁举, 乔群. 逆向工程技术在乳房整形中的应用研究[J/OL]. 中华乳腺病杂志(电子版), 2011, 05(02): 127-135.
[4]	王珍祥, 戴霞, 任校峰, 李世荣, 吴军. 聚丙烯酰胺水凝胶注射式隆乳术后哺乳期感染及其处理[J/OL]. 中华乳腺病杂志(电子版), 2011, 05(01): 15-17.
[5]	范林军, 姜军, 杨新华, 张毅, 陈显春. 腔镜技术在隆乳剂取出术中的应用:附45例报道[J/OL]. 中华乳腺病杂志(电子版), 2009, 03(06): 600-609.
[6]	林红, 施莹莹, 黄玲, 张琳. 聚丙烯酰胺水凝胶注射式隆乳术后并发症的处理[J/OL]. 中华乳腺病杂志(电子版), 2008, 02(03): 44-45.
[7]	刘鹏熙, 钟少文, 陈前军, 王一安, 赖熙雯, 林毅. 乳腺癌保乳术后背阔肌微肌瓣转移乳房整形[J/OL]. 中华乳腺病杂志(电子版), 2007, 01(01): 16-18.
[8]	任尊, 蔡伟杰, 张瑜博, 卢玉祥, 程鹏飞, 徐铮宇, 韩培. 脱细胞异体真皮与自体刃厚皮片联合移植修复足踝部非负重区创面的临床研究[J/OL]. 中华损伤与修复杂志(电子版), 2022, 17(05): 399-404.
[9]	韩飞, 张万福, 胡晓龙, 佟琳, 官浩. 脱细胞异体真皮联合自体刃厚皮修复大面积烧伤后关节部位瘢痕挛缩[J/OL]. 中华损伤与修复杂志(电子版), 2022, 17(03): 221-226.
[10]	杜露, 丰锦春, 吴涛, 吐鲁洪·沙列尔, 王斌, 杨亮, 赵倩, 迪力夏提·金斯汗, 许文婷, 朱丽萍. 保留乳头乳晕复合体乳腺癌术后脱细胞异体真皮辅助乳房再造的效果评价[J/OL]. 中华普通外科学文献(电子版), 2018, 12(05): 354-358.

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Combination of acellular allogenic dermis with silicone prosthesis implant to correct secondary deformities of the breast after operation

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Combination of acellular allogenic dermis with silicone prosthesis implant to correct secondary deformities of the breast after operation