title: Complications of skin-sparing mastectomy followed by immediate breast reconstruction: a prospective randomized study comparing high-frequency radiosurgery with conventional diathermy.
abstract: Skin-sparing mastectomy (SSM) followed by immediate breast reconstruction delivers superior cosmetic and functional outcome. However, SSM is vulnerable to complications of the native skin envelope. This study aims to compare the effects of radiofrequency coagulation and conventional diathermy on complications of SSM. Sixty consecutive patients suitable for SSM were randomized into conventional diathermy and radiosurgery groups. These groups were compared and the risk factors for SSM flap complications were evaluated. The SSM flap complication rate was 23.4%. There was no difference between the study groups regarding the SSM flap complications. Increased SSM flap complication rate was associated with smoking and the type of skin incision used. This study shows that high-frequency radiosurgery is comparable to conventional diathermy in terms of complication rates of SSM. Furthermore, this study reports an association between the tennis-racquet-type incision and an increased SSM flap complication rate compared with the round periareolar type incision.
authors.affiliation: Helsinki University Central Hospital, Department of Plastic Surgery and Breast Surgery Unit, Helsinki, Finland. tuomo.meretoja@utu.fi
authors.forename: Tuomo J
authors.initials: TJ
authors.lastname: Meretoja
authors.forename: Karl A J
authors.initials: KA
authors.lastname: von Smitten
authors.forename: Hannu O M
authors.initials: HO
authors.lastname: Kuokkanen
authors.forename: Sinikka H H
authors.initials: SH
authors.lastname: Suominen
authors.forename: Tiina A
authors.initials: TA
authors.lastname: Jahkola
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D044584:Carcinoma, Ductal / Q000601:surgery; D003972:Diathermy / Q000009:adverse effects; D004564:Electrocoagulation / Q000009:adverse effects; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D009336:Necrosis; D011446:Prospective Studies; D012307:Risk Factors; D012867:Skin / Q000473:pathology; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013524:Surgical Flaps