DOI: 10.1097/01.prs.0000464062.41730.03

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Issn Print: 0032-1052

Publication Date: 2015/04/01


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Abstract P93: Three Years Experience with Absorbable Mesh in Single-Stage Breast Reconstruction

William G. Austen; Robert Neumann; Oren Tessler; Daniel Maman; Barbara L. Smith; Heather R. Faulkner

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PURPOSE: The current circumstances of US healthcare mandate elimination of unnecessary costs while increasing efficiency in patient care. Traditional implant-based breast reconstruction encompasses multiple stages and using acellular dermal matrix (ADM); both increase cost. The senior author (WGA) has used absorbable knitted mesh (Vicryl™ - polyglactin 910) as an inferior pole sling in single-stage direct-to-implant (DTI) breast reconstruction since 2011. We report 3 year outcomes and cost savings data using this material.
METHODS: All patients who underwent DTI with mesh since 2011 were entered retrospectively into our database. Information captured includes demographics, intraoperative/postoperative data, cancer-related therapies, and comorbidities.
RESULTS: DTI was performed on 149 patients (54 unilateral, 95 bilateral; 244 breasts). Mean age was 51.9 years. Mean postop time was 21.1 months. Prophylactic mastectomy rate was 38.5%. Percentage of irradiated breasts (pre- or postoperative) was 28.7%. Infection rate was 1.6% (n = 4 breasts). Five implants (2%) were exposed (3 were salvaged). Seven implants (2.9%) were removed. Nine breasts (3.7%) had capsular contracture (5 had additional surgery: 2 flaps, 3 capsulotomy/capsulectomy with implant exchange). Capsular contracture was significantly greater in irradiated breasts (10% versus 1.1%, p = 0.0008). Material cost savings using mesh over ADM was above $550,000.
CONCLUSIONS: We have 3 years experience using absorbable mesh for DTI. We maintain a low complication rate, excellent aesthetic outcomes, and have achieved substantial efficiency and cost reduction.

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