Uticaj augmentacione mamaplastike na temperaturu kože dojke
Sažetak
Uvod/Cilj. Komplikacije augmentacije grudi, kao jedne od najčešćih estetskih operacija, su moguće i različite. Osim uobičajenih ranih, lokalnih postoperativnih komplikacija, najčešća kasna komplikacija je kapsularna kontraktura. Kao specifična komplikacija poremećaja funkcije kože posle ove operacije opisan je samo poremećaj senzibiliteta. S obzirom na to da koža ima i druge funkcije, kao i zbog toga što ne postoje podaci u literaturi, cilj istraživanja bio je merenje temperature kože dojke pre i posle operacije. Metode. Urađena je prospektivna intervencijska studija kod 49 punoletnih žena koje nisu rađale. Bilateralna augmentaciona mamoplastika je rađena zbog hipoplazije dojki ili na lični zahtev pacijenta sa eutrofičnim dojkama. Merenje temperature kože dojke je rađeno u dve tačke, pre operacije, sedam dana posle operacije i tri meseca posle operacije. Merenje temperature je učinjeno infracrvenim termometrom (Pyrometer BP21 TROTEC). Statistička značajnost razlike je određena korišćenjem t-testa za vezane uzorke. Razlike su smatrane statistički značajnim ukoliko je p < 0,05. Koeficijent eta kvadrat određivao je veličinu uticaja i prema kriterijumu Cohena, sve preko 0,14 označavalo je veliki uticaj. Dobijeni su analizirani programom IBM SPSS Statistics v20. Rezultati. Kod većine ispitanica dojke su bile hipoplastične (69,39%). Najčešće su korišćeni implantati zapremine 275–500 mL (46,94%), a najređe implantati zapremine preko 500 mL (16,33%). Kod nešto manje od 2/3 pacijenata primenjen je submamarni rez (61,22%). Kod većine pacijenata (67,35%), proteza je plasirana subglandularno. Prosečna vrednost temperature pre operacije u tački 1 bila je 34,49°C, sedam dana nakon operacije 34,81°C, a tri meseca nakon operacije 34,10°C, a u tački 2: 34,60°C, 34,91°C i 34,19°C u istim vremenskim intervalima. U odnosu na veličinu dojki pre operacije, veličinu i proizvođača implantata, lokalizaciju incizije i lokalizaciju plasiranja proteze, nisu nađene statistički značajne razlike u temperaturi kože dojke pre i posle operacije. Zaključak. Naši rezultati o promeni temperature kože dojke posle augmentacije mogli bi da imaju značaj u preoperativnom informisanju pacijenta.
Reference
American Society of Plastic Surgeons. National Clearinghouse of Plastic Surgery Procedural Statistics. 2013 Plastic Surgery Sta-tistics Report. American Society of Plastic Surgeons; 2014.
Codner MA, Mejia JD, Locke MB, Mahoney A, Thiels C, Nahai FR, et al. A 15-year experience with primary breast augmenta-tion. Plast Reconstr Surg 2011; 127(3): 1300–10.
Swanson E. Prospective outcome study of 225 cases of breast augmentation. Plast Reconstr Surg 2013; 131(5): 1158–66.
Hidalgo DA, Sinno S. Current Trends and Controversies in Breast Augmentation. Plast Reconstr Surg 2016; 137(4): 1142–50.
Namnoum JD, Largent J, Kaplan HM, Oefelein MG, Brown MH. Primary breast augmentation clinical trial outcomes stratified by surgical incision, anatomical placement and implant device type. J Plast Reconstr Aesthet Surg 2013; 66(9): 1165–72.
Adams WP, Small KH. The Process of Breast Augmentation with Special Focus on Patient Education, Patient Selection and Implant Selection. Clin Plast Surg 2015; 42(4): 413–26.
Vitug A, Newman L. Complications in Breast Suregry. Surg Clin N Am 2007; 87(4): 431–51.
Shi H, Cao C, Li X, Chen L, Li S. A retrospective study of primary breast augmentation: Recovery period, complications and patient satisfaction. Int J Clin Exp Med 2015; 8(10): 18737–43.
Headon H, Kasem A, Mokbel K. Capsular Contracture after Breast Augmentation: An Update for Clinical Practice. Arch Plast Surg 2015; 42(5): 532–43.
Okwueze MI, Spear ME, Zwyghuizen AM, Braün SA, Ajmal N, Nanney LB, et al. Effect of augmentation mammaplasty on breast sensation. Plast Reconstr Surg 2006; 117(1): 73–83; discussion 84–5.
Mofid M, Klatsky SA, Singh NK, Nahabedian MY. Nipple-areola complex sensitivity after primary breast augmentation: A comparison of periareolar and inframammary incision ap-proaches. Plast Reconstr Surg 2006; 117(6): 1694–8.
Araco A, Araco F, Sorge R, Gravante G. Sensitivity of the nip-ple-areola complex and areolar pain following aesthetic breast augmentation in a retrospective series of 1200 patients: Peri-areolar versus submammary incision. Plast Reconstr Surg 2011; 128(4): 984–9.
Lund HG, Turkle J, Jewell ML, Murphy DK. Low Risk of Skin and Nipple Sensitivity and Lactation Issues After Primary Breast Augmentation with Form-Stable Silicone Implants: Follow-Up in 4927 Subjects. Aesthet Surg J 2016; 36(6): 672–80.
Xu J, Wei S. Breast implant-associated anaplastic large cell lymphoma: Review of a distinct clinicopathologic entity. Arch Pathol Lab Med 2014; 138(6): 842–6.
Staffa E, Bernard V, Kubíček L, Vlachovský R, Vlk D, Mornstein V, et al. Using Noncontact Infrared Thermography for Long-term Monitoring of Foot Temperatures in a Patient with Dia-betes Mellitus. Ostomy Wound Manage 2016; 62(4): 54–61.
Greenwald M, Ball J, Guerrettaz K, Paulus H. Using dermal Temperature to identify rheumatoid arthritis examiners with radiologic progressive disease in less than one minute. Arthritis Care Res 2016; 68(8): 1201–5.
Engebretsen KA, Johansen JD, Kezic S, Linneberg A, Thyssen JP. The effect of environmental humidity and temperature on skin barrier function and dermatitis. J Eur Acad Dermatol Venereol 2016; 30(2): 223–49.
Jones NF. Postoperative monitoring of microsurgical free tis-sue transfers for head and neck reconstruction. Microsurgery 1988; 9(2): 159–64.
Furnas H, Rosen JM. Monitoring in microvascular surgery. Ann Plast Surg 1991; 26(3): 265–72.
Kozarski J, Pantelić Lj, Novaković M, Pavlica M, Panajotović Lj. Temperature of the skin in microvascular flaps. Vojnosanit Pregl 1999; 56(5): 483–9. (Serbian)
Kraemer R, Lorenzen J, Knobloch K, Papst S, Kabbani M, Koenneck-er S, et al. Free flap microcirculatory monitoring correlates to free flap temperature assessment. J Plast Reconstr Aesthet Surg 2011; 64(10): 1353–8.
Gazzola R, Cavallini M, Parodi PC, Benanti E, Vaienti L. Radi-ometric infrared temperature detection in skin expansion. Plast Reconstr Surg 2012; 130(5): 762e–4e.
Kimura C, Matsuoka M. Changes in breast skin temperature during the course of breastfeeding. J Hum Lact 2007; 23(1): 60–9.
Ayres B, White J, Hedger W, Scurr J. Female upper body and breast skin temperature and thermal comfort following exer-cise. Ergonomics 2013; 56(7): 1194–202.
Wynn TA. Common and unique mechanisms regulate fibrosis in various fibroproliferative diseases. J Clin Invest 2007; 117(3): 524–9.
Gauldie J. Pro: inflammatory mechanisms are a minor compo-nent of the pathogenesis of idiopathic pulmonary fibrosis. Am J Resp Crit Care Med 2002; 165(9): 1205–6.
Erjefalt JS, Sundler F, Persson CG. Eosinophils, neutrophils, and venular gaps in the airway mucosa at epithelial removal: Restitution. Am J Resp Crit Care Med 1996; 153(5): 1666–74.
Bringardner BD, Baran CP, Eubank TD, Marsh CB. The role of inflammation in the pathogenesis of idiopathic pulmonary fi-brosis. Antioxid Redox Signal 2008; 10(2): 287–301.
Agostini C, Gurrieri C. Chemokine/cytokine cocktail in idio-pathic pulmonary fibrosis. Proc Am Thorac Soc 2006; 3(4): 357–63.
Iwano M, Plieth D, Danoff TM, Xue C, Okada H, Neilson EG. Evidence that fibroblasts derive from epithelium during tissue fibrosis. J Clin Invest 2002; 110(3): 341–50.
Ojo-Amaize EA, Lawless OJ, Peter JB. Elevated concentrations of interleukin-1 beta and interleukin-1 receptor antagonist in plasma of women with silicone breast implants. Clin Diagn Lab Immunol 1996; 3(3): 257–9.
Rohde CH, Taylor EM, Alonso A, Ascherman JA, Hardy KL, Pilla AA. Pulsed Electromagnetic Fields Reduce Postoperative In-terleukin-1β, Pain, and Inflammation: A Double-Blind, Place-bo-Controlled Study in TRAM Flap Breast Reconstruction Patients. Plast Reconstr Surg 2015; 135(5): 808–17.