Authors: Stefano Pompei, MD, Dora Evangelidou,MD, MRM, Floriana Arelli, MD, Gianluigi Ferrante, MD, MSc
Abstract
The use of acellular dermal matrices (ADM) and synthetic meshes in breast surgery is gaining popularity in recent years.
It is well documented in the literature that synthetic meshes are viable alternatives to ADMs.
This article documents the authors’ experience in the use of a synthetic 100% bioresorbable surgical mesh (TIGR Matrix, Novus Scientific, Uppsala,Sweden) in breast reconstruction as well as in breast aesthetic surgery.
Methods
A retrospective review of patients who underwent implant-based breast reconstruction as well as patients who underwent breast reduction mammoplasty procedures with the use of the TIGR Matrix Surgical Mesh.
Forty-nine consecutive patients were included in the study between 2014-2016.
There were no exclusion criteria. Complications and surgical revision rate data were collected and documented.
Placement of tissue expander (TE) with mesh or direct to implant (DTI) with mesh breast reconstruction immediately after mastectomy.
TIGR mesh was sutured to the muscle’s lower border inferiorly. The mesh was subsequently sutured to the chest wall at the desired level of the newly created inframammary fold. In order to maximize the contact surface between the implant and the pocket walls, suction drains were placed in every patient. The TIGR matrix was used to stabilize the flap and to secure it on the pectoral fascia.
Results
A total of 60 meshes were used in 60 breast surgeries.
One device was lost because of prosthesis removal due to skin necrosis. For 54 breast reconstructions performed using mesh, 35 were after skin-sparing mastectomy, 13 were after nipple-sparing mastectomy, and 4 were after skin-reducing mastectomy. Two meshes were used to treat contour deformities in secondary reconstruction attempts.
Capsular contracture was observed in one reconstructed breast (1.7%). Three reconstructed breasts exhibited incision dehiscence (5.0%), 4 breasts exhibited postoperative hematoma (6.7%), and in 3 breasts, skin necrosis was observed (5.0%). Infection was reported in one reconstructed breast (1.7%), whereas seroma was observed in 2 (3.3%).
Conclusions
Synthetic mesh is a viable alternative to acellular dermal matrices when used in breast surgery. The use of a 100% resorbable synthetic mesh in implant-based breast reconstruction significantly lowers the reconstruction cost while maintaining the benefits of tissue enforcement in the lower pole.
TIGR Matrix exhibits promising preliminary results when used in breast surgery, such as low seroma and infection rates, when compared with non-resorbable or semi-resorbable synthetic meshes.