Abstract A new kind of soft tissue expander with exteriorized injection valve was reported. Two types of expanders were designed: one with single cyst, single tube and single chamber, and the other with single cyst, single tube but double chambers, i.e, an additional drainage chamber. The drainage orifice could be controlled by a valve. An animal experiment had been conducted, and the outcome suggested that the new expander could provide rapid expansion of the soft tissue, sufficient drainage of the expanded area. The bacterial culture showed that among the 42 samples obtained from the expanded cyst, only 3 were positive. (2 of bacteria and 1 of fungus), suggesting comparatively low cyst infection.
ObjectiveTo explore the causes and prevention measures of the cracking of skin tissue expander applied for ear deformity surgery. MethodsWe retrospectively analyzed the clinical data of the patients who underwent ear reconstruction surgery with skin tissue expander which cracked during water injection after surgery between January 2013 and March 2015. And then we analyzed the causes and summarized the preventive measures, such as strengthening health education, protective ear cap application, and correct water injection. ResultsWe collected a total of 149 patients including 153 deformity ears, and 151 skin tissue expanders were used. Skin tissue expander cracking occurred in 7 ears during water injection after surgery with an incidence of 4.64%. Among the seven cases, 5 cases of cracking occurred in the late water injection period when the skin flap size was almost close to expectations; these 5 patients underwent stage-two surgery after the expanders were taken out, and the results were satisfactory. The other 2 ears had expander cracking in the early water injection period, so we took out the skin tissue expander and implanted it again, and the second phase surgery was also satisfactory. The third-stage surgery for the seven cases was all successful. After the third-stage surgery, all patients were followed up for 3 to 6 months, and the outcomes were satisfying without any complications. ConclusionTo reduce or avoid skin tissue expander cracking, we should master strict terms of water injection and take effective health education and preventive measures.
ObjectiveTo analyze the value of indocyanine green (ICG) fluorescence imaging in the evaluation of blood flown of ipple-areola complex (NAC) and implant selection during single-port endoscopic breast reconstruction. Methods From November 2018 to March 2020, 19 patients who underwent single-port inflatable endoscopic nipple-sparing mastectomy combined with breast reconstruction in Beijing Friendship Hospital were retrospectively collected. ICG fluorescence imaging technology was used to evaluate the blood supply pattern and the risk of ischemic necrosis of NAC, so as to guide the selection of implant. At the same time, 14 patients who underwent single-port inflatable endoscopic nipple-sparing mastectomy combined with breast reconstruction in Beijing Friendship Hospital from February 2017 to October 2018 were selected as the historical control group (control group). NAC ischemic necrosis, breast satisfaction and implant removal were compared between the two groups. Results In the ICG group, there were3 cases of V1 pattern and 2 cases of NAC ischemic necrosis (1 case of grade 1, 1 case of grade 2). There was no NAC ischemic necrosis in 16 patients with V2 mode and V3 mode. No implant loss occurred in any of the patients. In the control group, 5 cases had NAC ischemic necrosis (all were severe ischemic necrosis), and 2 cases had implant loss. The rate of severe NAC ischemic necrosis in the ICG group was lower than that in the control group (P<0.01), but there was no significant difference in implant loss rate between the two groups (P=0.17). The breast satisfaction score of the ICG group was higher than that of the control group (P<0.01), but there were no significant difference in satisfaction scores of chestwell-being, psychological well-being and sexual well-being between the two groups (P>0.05). Conclusions ICG imaging can be used to evaluate the blood supply pattern during the operation of prosthetic body mass reconstruction, guide the choice of implant in immediate breast reconstruction, so as to further improve postoperative breast satisfaction.