Use of an absorbable adhesion barrier for reconstruction of partial mastectomy defects in the upper quadrant of large ptotic breasts

Abstract

IntroductionAn absorbable adhesion barrier (Interceed®) is generally used during gynecologic or pelvic surgery. We report a new oncoplastic technique using the absorbable Interceed® sheet for upper quadrant breast cancer in large ptotic breasts with no other flaps. Materials and methodsFrom January 2007 to June 2013, a total of 25 patients with breast cancer underwent conventional breast-conserving surgery with the Interceed® sheet insertion technique. Tumors were removed with oncologically safe margins, and adjacent breast tissue was repositioned to adjust the breast's shape. When shaping was completed, the breast skin turgor was strengthened using Burrow's triangle displacement technique. Interceed® was then placed between breast skin and pectoralis muscle fascia with four-quadrant anchoring sutures. ResultsThe tumors were located in the upper central (n = 12), upper inner (n = 11), and upper outer (n = 2) quadrants. The mean weight of the removed breasts was 82.1 g, and the mean operative time was 161.3 min. There were two postoperative complications—a wound infection and fat necrosis—which were resolved with conservative management. Radiation-induced fibrosis and skin thickening were identified by magnetic resonance imaging 8–12 weeks after radiotherapy. Overall patient and surgeon satisfaction with the cosmetic results were evaluated as excellent (n = 12), good (n = 11), or fair (n = 2). ConclusionUse of the absorbable Interceed® sheet during surgery for upper quadrant breast cancer is feasible in patients with large ptotic breasts.