Clinical experiences with the use of ULTRAPRO® mesh in single-stage direct-to-implant immediate postmastectomy breast reconstruction in 102 patients: a retrospective cohort study

Publication date: Available online 6 February 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Dávid Pukancsik, Péter Kelemen, Gusztáv Gulyás, Mihály Újhelyi, Eszter Kovács, Klára Éles, Norbert Mészáros, István Kenessey, Péter Pálházi, Tibor Kovács, Miklós Kásler, Zoltán Mátrai
BackgroundAcellular dermal matrices have been used for direct-to-implant (DTI) breast reconstruction (BR), eliminating the load of the lower pole skin envelope. However, the available allograft matrices add considerable health care costs.This study examined the long-term follow-up of synthetic ULTRAPRO^® mesh as a low-cost potential alternative to biological matrices.Patients and methodsA retrospective cohort study was performed between January 2013 and January 2016, involved 112 early-stage breast cancer and/or BRCA 1/2 patients, and evaluated 189 immediate DTI BRs following skin-, areola- or nipple-sparing mastectomy using ULTRAPRO^® mesh. Patient characteristics and postoperative complications were recorded, and quality of life was rated by the patients using the EORTC-QLQ-C30-BR23 questionnaire.Aesthetic outcomes and palpability of the implants were evaluated by four breast surgeons on a 5-point Likert scale. All recorded parameters were statistically analysed.ResultsTen patients were lost-to-follow-up, resulting in 102 patients and 174 breast surgery cases analysed. The mean age was 43 years, with 23.4 months of follow-up on average. Forty-six patients (45.1%) had previous radiotherapy with pre-existing scars. In total, 32 complications (18.3%) were recorded, including 12 minor (6.9%) and 20 major (11.4%) complications requiring revision. All median quality of life scores were above 83 points, representing a high score, with an average 4-point rating for the aesthetic outcome and natural consistency of the breast.ConclusionPartially absorbable ULTRAPRO^® mesh could be used successfully in DTI BR, offering a safe, less expensive alternative to biological matrices. Adequate indications and patient selection are necessary.



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