An algorithmic approach for selective acellular dermal matrix use in immediate two-stage breast reconstruction

An algorithmic approach for selective acellular dermal matrix use in immediate two-stage breast reconstruction: Indications and outcomes. Plastic and Reconstructive Surgery Aug 2014, Vol. 134(2), p.178-88.

Jordan, S.W., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2014/08000/An_Algorithmic_Approach_for_Selective_Acellular.4.aspx

Acellular dermal matrix use has gained widespread acceptance—despite higher material costs—because of its ease of use and potential for enhanced cosmesis. The authors developed a resource-sensitive algorithm for selective acellular dermal matrix use with indications and contraindications based on body mass index, breast size, radiation therapy, flap vascularity, and pectoralis anatomy. Methods: The algorithm incorporates preoperative and intraoperative decision points. Complication rates and aesthetic scores were compared for procedures performed before and after adoption of the algorithm. Multiple logistic regression was used to determine the independent influence of the algorithm on postoperative outcomes.

Breast reconstruction with tissue expanders

Breast reconstruction with tissue expanders: Implementation of a standardized best practices protocol to reduce infection rates. Plastic and Reconstructive Surgery July 2014, Vol. 134(1), p.11-18.

Khansa, I., et al.

http://journals.lww.com/plasreconsurg/Abstract/2014/07000/Breast_Reconstruction_with_Tissue_Expanders__.4.aspx

Periprosthetic infection remains a frustrating and costly complication of breast reconstruction with tissue expanders. Although some specific steps have been previously shown to reduce periprosthetic infections, no comprehensive protocol addressing all aspects of preoperative, intraoperative, and postoperative patient management has been evaluated in the literature. The authors’ goal was to evaluate the effectiveness of their protocol at reducing periprosthetic infections.

Silicone gel breast implants: Science and testing

Silicone gel breast implants: Science and testing. Plastic and Reconstructive Surgery, July 2014, Vol.134 (1s).

Kinney, B.M., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2014/07001/Silicone_Gel_Breast_Implants___Science_and_Testing.9.aspx

Since the first generation of breast implants, major design innovations, including consistency of the gel, palpability and thickness of the shell, and barrier materials in the shell, have been introduced. Surgeons have not had metrics to assess and compare available implants.

Methods: Research at independent laboratories included 4 tests: gel elasticity (the gel’s ability to retain its shape), gel compression fracture (the resistance to permanent gel deformation), gel-shell peel (the integration of the gel with shell as a cohesive unit), and morphological analysis.

Breast embryology and the double-bubble deformity

Breast embryology and the double-bubble deformity. Plastic and Reconstructive Surgery, July 2014, Vol. 134(1), p.161e-162e.

Gigliofiorito, P., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2014/07000/Breast_Embryology_and_the_Double_Bubble_Deformity.42.aspx

Breast surgery remains one of the most popular branches of plastic surgery. More than 286,000 breast implants were placed in 2012 in the United States, and these numbers will probably increase in the next decade. The double-bubble deformity can be a disappointing complication during breast surgery, and patients often relate to it as a surgical mistake. However, as the author stated, it can also be a consequence of a patient’s own susceptibility.

NEJM Audio Summary: Breast cancer

NEJM Audio Summary: Breast cancer risk. Aug 2014 [podcast]

Breast-cancer risk and mutations in PALB2

http://podcast.nejm.org/summaries/nejm_2014.371.issue-6.summary.mp3