The New Fabric for Sling Method in Expander-Implant Immediate Breast Reconstruction

Immediate breast reconstruction based on tissue expander(TE) and implant has been popular method and the most used reconstruction procedure. To reduce the risk of implant exposure due to poor skin perfusion following mastectomy, implant is inserted beneath pectoralis major muscle, covering especially upper pole of TE at first stage. Currently, acellular dermal matrix(ADM) or some artificial material sheet have been used in implant-based breast reconstruction, which cover lower lateral pole of TE to create larger submuscular pocket and natural breast shape.

The advantage synthetic biomaterials compared with ADM is no limits of supply and easily available and its cost is lower than ADM. Some reports about sling method using synthetic biomaterial sheet suggest its safety and cost effectiveness, but there are few studies with high evidence level. We focused on the newbioabsorbable polyglicolic acid (PGA) felt developed as a scaffold on regenerative medicine. In recent years, this material has also been used to reinforce on surgical suture stitch or prevent air leakage in thoracic surgery. In this study, we used this material for immediate breast reconstruction with TE using sling method. It differs from other biomaterials that can be expected to have superior properties as tissue regeneration with sufficient strength up to growth of soft tissue into the sheet. We report a prospective study protocol to assess the safety and usefulness of this new PGA felt for immediate breast reconstruction based on TE.