PROSTHESIS EXPOSURE MANAGEMENT AFTER IMMEDIATE BREAST RECONSTRUCTION

Cícero de Andrade Urban1, Rafael Amin Menezes Hassan1, Rubens Silveira de Lima2

1 Universidade Positivo – Mestrado de Biotecnologia industrial

2 Hospital Nossa senhora das Graças – Departamento de mastologia

SUMMARY

INTRODUCTION: Breast cancer is the most frequent malignant neoplasm among women. When diagnosed at an early stage,

it has a good prognosis. With the biotechnological development of the prostheses and the advent of oncoplastics, the surgeries

started to present a better cosmetic result, bringing with it psychological and functional benefits, without compromising the

oncological character of the treatment. Breast reconstruction with the use of prostheses is far from achieving low complication

rates, making studies of a great relevance that can help to define and improve the behavior in cases of complicating prosthesis

surgeries. The objective of the study was to evaluate the flowchart adopted by a single team of breast surgery for guidance of

therapeutic management in patients submitted to breast reconstruction who evolved with prosthesis exposure. METHODS:

Retrospective analysis of the database included reconstructed patients with use of definitive or temporary breast implants

between 2014 and June 2016. The epidemiological characteristics of the population were evaluated; type of surgery and

prosthesis mark; postoperative follow-up; and application of the conduit flow chart, which includes history of radiotherapy,

presence of severe infection and extensive necrosis. RESULTS: There were 56 complications (20.2%), 33 cases were exposed

prostheses and had criteria for application of the conduit protocol, of which 14 had criteria for simple suture, with a success

rate of 57.1%. At the final outcome, nine had loss of breast reconstruction and 24 remained with reconstructed breasts.

CONCLUSIONS: The protocol for ducts for exposed prostheses, evaluated in this study, showed results with acceptable

efficacy and good reproducibility, facilitating its application in future studies.

Key words: Breast cancer, mastectomy, breast reconstruction, breast implant.