Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Predictors of postoperative complications and unplanned reoperations 90 days following immediate alloplastic breast reconstruction.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Biswas Arushi, Osei Briana, Tiongco Rafael Felix P, Zhu Katherine J, Atayeva Rena, Khan Iman F, Duclos Olga A, Sulaiman Hafsa O, Heron Matthew J, Weitzner Aidan S, Zhu Lily, Khong Jeffrey, Sim Danielle J, Rodriguez-Silva Waldemar A, Cooney Carisa M, Cooney Damon S
Аннотация
BACKGROUND: Implant-based breast reconstruction is common and may result in postoperative complications/unplanned reoperation within 90 days of surgery. We aimed to characterize postoperative complications and unplanned reoperations within 90 days of immediate alloplastic breast reconstruction and identify pre- and intraoperative factors that are independently associated with these outcomes.
METHODS: We retrospectively reviewed patients ≥18 years who underwent mastectomy and immediate alloplastic breast reconstruction at five institutions in our health system from July 2016 through February 2022. We abstracted patient demographics, surgical details, and 48-hour and 90-day postoperative complications/unplanned reoperations. We performed bivariate analyses and multivariate regressions to identify associations between 90-day postoperative complications/unplanned reoperations and patient/surgical factors. Significance was set at p<0.05.
RESULTS: We included 1196 patients with median age of 51 years and median body mass index (BMI) of 24.9 kg/m2. Two hundred seventeen patients (18.1%) experienced 367 complications including infection (9.2%), mastectomy skin necrosis (6.0%), seroma (4.0%), and wound dehiscence (1.8%). One hundred fifty-three patients (12.8%) underwent unplanned reoperation [e.g., tissue expander/implant removal without replacement (6.9%) and debridement (6.7%)]. On multivariate analysis, autoimmune conditions (OR 2.00, 95% CI 1.05-3.83, p=0.036), prophylactic mastectomy (OR 1.74, 95% CI 1.06-2.84, p=0.027), bilateral mastectomy (OR 1.63, 95% CI 1.17-2.27, p=0.004), and BMI ≥30 kg/m2 (OR 1.53, 95% CI 1.01-2.32, p=0.043) were associated with 90-day complications. Autoimmune conditions (OR 2.51, 95% CI 1.27-4.98, p=0.008) and prophylactic mastectomy (OR 2.11, 95% CI 1.23-3.62, p=0.007) were associated with unplanned reoperations.
CONCLUSIONS: Autoimmune conditions, prophylactic mastectomy, bilateral procedures, and BMI ≥30 kg/m2 were independent predictors of adverse postoperative outcomes. Patients with these factors may benefit from closer postoperative follow-up.
METHODS: We retrospectively reviewed patients ≥18 years who underwent mastectomy and immediate alloplastic breast reconstruction at five institutions in our health system from July 2016 through February 2022. We abstracted patient demographics, surgical details, and 48-hour and 90-day postoperative complications/unplanned reoperations. We performed bivariate analyses and multivariate regressions to identify associations between 90-day postoperative complications/unplanned reoperations and patient/surgical factors. Significance was set at p<0.05.
RESULTS: We included 1196 patients with median age of 51 years and median body mass index (BMI) of 24.9 kg/m2. Two hundred seventeen patients (18.1%) experienced 367 complications including infection (9.2%), mastectomy skin necrosis (6.0%), seroma (4.0%), and wound dehiscence (1.8%). One hundred fifty-three patients (12.8%) underwent unplanned reoperation [e.g., tissue expander/implant removal without replacement (6.9%) and debridement (6.7%)]. On multivariate analysis, autoimmune conditions (OR 2.00, 95% CI 1.05-3.83, p=0.036), prophylactic mastectomy (OR 1.74, 95% CI 1.06-2.84, p=0.027), bilateral mastectomy (OR 1.63, 95% CI 1.17-2.27, p=0.004), and BMI ≥30 kg/m2 (OR 1.53, 95% CI 1.01-2.32, p=0.043) were associated with 90-day complications. Autoimmune conditions (OR 2.51, 95% CI 1.27-4.98, p=0.008) and prophylactic mastectomy (OR 2.11, 95% CI 1.23-3.62, p=0.007) were associated with unplanned reoperations.
CONCLUSIONS: Autoimmune conditions, prophylactic mastectomy, bilateral procedures, and BMI ≥30 kg/m2 were independent predictors of adverse postoperative outcomes. Patients with these factors may benefit from closer postoperative follow-up.