title: Breast reconstruction with absorbable mesh sling: dynamic infrared thermography of skin envelope.
abstract: BACKGROUND
  To immediate reconstruct ptosis breasts, we used polyglactin (Vicryl; Ethicon Inc., Somerville, NJ, USA) mesh as an inferolateral sling. However, Vicryl mesh is absorbable and losing function as a supporting structure. We doubt about the stability of the blood supply to the inferior part of the flap when it is in direct contact with inner implant. In this study, we examine the complications and the safety of the skin flap of this absorbable mesh sling (AMS) procedure.
  
  
  METHODS
  The outcomes of 80 cases were examined, and the 1-year safety record of 40 cases was assessed. Complications were divided into minor complications, major complications requiring surgical intervention, and major complications requiring the reconstructive surgery to be halted. In addition, we examined the blood perfusion of the skin flap by dynamic infrared thermography (DIRT).
  
  
  RESULTS
  Among 80 patients with AMS procedure, 73 breasts were reconstructed immediately and in one-stage. Complication outcomes are presented; there were 4 cases of minor flap necrosis (5%) and 4 of major complications resulting in surgical correction (5%). One patient required additional surgery, and the implant was moved into the musculocutaneous flap (1.3%). In 40 patients 1 year after surgery, DIRT showed significant decreased of blood perfusion in the ipsilateral inferior sites in comparison with the superior sites.
  
  
  CONCLUSIONS
  Blood perfusion was comparably insufficient in the inferior area of the reconstructed breast mound with AMS, where the pectoralis muscle could not be used to line the inside of the envelope. However, there were no severe flap complications due to ischemia.
authors.affiliation: Department of Breast Surgery, Japanese Red Cross Society of Himeji, Himeji, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Breast Surgery, Japanese Red Cross Society of Himeji, Himeji, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Watanabe
authors.affiliation: Department of Breast Surgery, Japanese Red Cross Society of Himeji, Himeji, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yuasa
authors.affiliation: Department of Plastic Surgery, Japanese Red Cross Society of Himeji, Himeji, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Plastic Surgery, Japanese Red Cross Society of Himeji, Himeji, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saisho
keywords: Breast reconstruction; Vicryl mesh; dynamic infrared thermography (DIRT); implant reconstruction; one-stage