Comparative Analysis And Follow-up Evaluation Of The Effect Of One-stage Breast Reconstruction And Two-stage Breast Reconstruction After Removal Of Polyacrylamide Hydrogel(PAHG) Injection Breast Augmentation

Objective:(1)To study the screening and feasibility of breast reconstruction with polyacrylamide hydrogel injection(PAHG)at the same time.(2)To study the screening and feasibility of breast reconstruction with polyacrylamide hydrogel injections(PAHG)during the first stage of soft tissue expansion and the second stage of breast replacement.Method:Methods from January 2014 to August 2018,26 cases of breast reconstruction group and 18 cases of silicone gel prosthesis augmentation mammoplasty were treated with polyacrylamide hydrogel injection(PAHG).In group A(observation group),11 patients were treated with polyacrylamide hydrogel injection(PAHG).The injection was concentrated in a space behind the gland or pectoral muscle.Ultrasound confirmed that there was no significant residual in other parts of PAHG.In group B(observation group),15 cases were taken out for polyacrylamide hydrogel injection(PAHG).The injection was dispersed in various layers,including subcutaneous,glandular and pectoral muscles.Ultrasound showed a little residual in other parts(layers)during PAHG removal.Group C(control group): 18 patients were treated with silicone gel prosthesis.The operation time,bleeding volume,drainage tube removal time,hospitalization time,incidence of complications,quality of life and satisfaction of patients in 1 month,6months and 12 months after operation were recorded and compared.Statistical software SPSS19.0 was used to analyze the data.T test and X2 exact test were used.The difference was significant with P < 0.05.Result:(1)Contrastive analysis of perioperative indicators:In observation group A,the operation time was(190.5 +20.2)min,the drainage tube extubation time was(12.6 +1.4)d,the hospitalization time was(12.6 +1.4)d,the intraoperative bleeding volume was(194.5%+19.2)ml;in observation group B,the first stage operation time was(191.3 +18.2)min,the drainage tube extubation time was(12.1+1.2)d,the hospitalization time was(12.1 +1.2)d,and the intraoperative bleeding volume was(188.5 +18.4)ml.The second stage of breast prosthesis replacement with expander in group B was(128.0(+19.6)min,the time of drainage tube extubation was(5.6(+1.0)d,the time of hospitalization was(5.6(+1.0)d,and the amount of bleeding during operation was(44.7(+5.0)ml.In the control group,the operation time was(97.5+ 15.7)min,the drainage tube extubation time was(4.9 + 1.0)d,the hospitalization time was(4.9 + 1.0)d,and the intraoperative bleeding volume was(41.1 + 7.0)ml.The operation time,intraoperative bleeding volume,drainage tube removal time and hospitalization time in group A were more than those in the control group(p < 0.05).Observation group B implanted dilator in the first stage,the operation time,intraoperative bleeding volume,drainage tube pull-out time,hospitalization time were more than those of control group(p < 0.05),while in the second stage,there was no significant difference between the two groups(p > 0.05),and there was no significant difference between implanted dilator and group A.(2)Comparative analysis of postoperative complications:Complications occurred in 2 patients in observation group A,with a probability of18.2%;3 patients in observation group B had complications,with a probability of 20.0%;and 2 patients in control group had complications,with an incidence of 11.1%.There was no significant difference in the incidence of complications between the two groups(p > 0.05),but the incidence of complications in the observation group was higher than that in the control group(P < 0.05).(3)A comparative analysis of quality of life and self-esteem after operation:There was no significant difference in the quality of life and self-esteem scale scores among the three groups(p > 0.05),and the scores increased gradually with the passage of time.(4)A comparative analysis of surgical effect and satisfaction with nursing quality:There was no significant difference in satisfaction with breast effect and nursing quality among the three groups(p > 0.05).Conclusion:(1)polyacrylamide hydrogel injection(PAHG)was removed.If the injection was confined to a lacuna,intraoperative ultrasound revealed no residual parts of the surrounding part.It could be implanted with silicone gel breast prosthesis at one time,but the incidence of postoperative complications was slightly higher than that of traditional prosthesis.(2)Polyacrylamide hydrogel injection(PAHG)can be removed.If the injection is dispersed in subcutaneous,in vivo,in pectoral muscles,and the ultrasound indication is uncertain,the soft tissue expansion period can be implanted first,and breast reconstruction with second-stage replacement breast prosthesis can be performed.The incidence of total complications is slightly higher.(3)The quality of life,self-esteem and satisfaction with the results of two PAHG removal methods after breast reconstruction are good,which are worthy of clinical application.