AI Article Synopsis
- - The study investigates the factors affecting the prolonged time for tissue expander (TE) to implant exchange in two-stage breast reconstruction, revealing that the average exchange time is 155 days, with prolonged cases defined as those taking longer than 232 days.
- - A retrospective review included 442 women who underwent immediate IBBR after total mastectomy, excluding those with irradiated TEs, and identified key factors related to delayed exchanges such as diabetes, neoadjuvant chemotherapy, longer hospital stays, and delay in outpatient expansions.
- - The findings indicate significant variability in exchange timing among patients and emphasize the importance of completing outpatient expansions promptly to speed up the transition to definitive implants.
Article Abstract
Background: There is limited evidence regarding the factors causing a prolonged time for tissue expander (TE) exchange into a definitive implant using two-stage implant-based breast reconstruction (IBBR). This study aimed to review our experience with IBBR, focusing on the time for TE-to-implant exchange and determining which factors cause a prolonged time for exchange.
Methods: A retrospective review was performed to include women undergoing immediate two-stage IBBR with TEs after total mastectomy between January 2011 and May 2021. Reconstructions with irradiated TEs were excluded. Cases that had a prolonged time for TE-to-implant exchange were defined as those undergoing exchange longer than 232 days, which corresponds to the 75th percentile of the overall study group.
Results: We included 442 reconstructions in our analysis. The median age for our series was 51 years and the median body mass index was 26.43-kg/m. The median time for TE-to-implant exchange was 155 days [IQR, 107-232]. Cases that had a prolonged time for TE-to-implant exchange were defined as those undergoing exchange on postoperative day 232 or afterward. Diabetes (OR 4.05, p = 0.006), neoadjuvant chemotherapy (OR 2.76, p = 0.006), an increased length of stay (OR 1.54, p = 0.013), and a lengthier time to complete outpatient expansions (OR 1.018, p < 0.001) were independently associated with a prolonged time for exchange.
Conclusion: As evident from our analysis, the time for exchange is highly heterogeneous among patients. Although several factors affect the timing for TE-to-implant exchange, efforts must be directed to finalize outpatient expansions as soon as possible to expedite the transition into a definitive implant.
Level Of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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| http://dx.doi.org/10.1007/s00266-023-03536-3 | DOI Listing |
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