44 Chapter 3 Infectious complications Infectious complications were reported in two of the five included articles.13, 16 In the report by Sandelin et al, five patients (2.7%) developed an infection, resulting in three cases (1.6%) of implant removal.16 Salgarello reported thirteen wound infections (6.4%). In two cases (0.9%) reoperation with implant removal was required.13 Reconstructive outcomes Reconstructive outcomes were described in the retrospective case series by Salgarello et al.13 These outcomes were not standardized, but based on the operator and other surgeons’ perception of the cosmetic result. The reconstructive outcomes of all immediate reconstructions with a definitive prosthesis were found to be very good or good in 78.6%, acceptable in 14.0% and poor in 7.3% of all cases. In 12 cases (5.4%) additional surgery was necessary to improve cosmetic results. Abdelhamid et al mentioned an improved aspect of the skin flaps after fascia preservation, but these statements were not based on any objective data.13 DISCUSSION This systematic review was performed to provide a comprehensive overview of the current literature concerning preservation of the fascia over the PM. Relevant outcomes were assessed, including oncological outcomes, complications and Table 3. Occurrence of complications in four studies reporting on complications. Study Reference Seroma Postoperative bleeding PF preservation PF removal P-value PF preservation PF removal P-value Dalberg, 2004 n= 31* (31.0%) n= 39* (39.8%) p=0.20 - - - Abdelhamid, 2017 n=2 (5.6%) n=9 (24.3%) P=0.025 - - - Sandelin, 2004 - - - N=2 (1.1%)** - - Salgarello, 2011 n=3 (1.3%) - - n=6 (2.7%) - - PF: pectoral fascia. *measured in the part of the total study sample also enrolled in the drainage trial. In the drainage trial patients were randomized between axillary drainage <24 hours regardless of drain production (n=99) or drainage until drain production <40cc/24u (n=99). **measured in the n=188 with implant reconstruction. The n=13 with TRAM reconstruction were left out of this table since it is impossible to know if complications are due to the mastectomy or TRAM reconstruction based on the current information provided.
RkJQdWJsaXNoZXIy MTk4NDMw