METHOD OF SINGLE-STAGE BREAST RECONSTRUCTION IN CANCER USING ACELLULAR DERMAL MATRIX AND SILICONE IMPLANT Russian patent published in 2016 - IPC A61B17/00 A61K35/36 A61P43/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to oncology and reconstructive plastic surgery. Method includes performing subcutaneous mastectomy and lymphadenectomy with single-step reconstruction with silicone implant. Greater pectoral muscle is mobilised by excision of lower edge of its attachment, lateral direction to level corresponding to 9:00 position. Undesirable part of greater pectoral muscle is separated from anterior chest wall and by electrodissection subpectoral pocket is formed to marked levels along perimeter of formed gland; after successful creation subpectoral pocket approximate size 4-8 cm × 14-16 cm sheet is acellular dermal matrix, its sharp edges cut circumferentially, immersed in 0.9 % normal saline edge matrix corresponding to bottom, is anchored by separate interrupted sutures atraumatic suture to fascia of anterior chest wall corresponding submammary fold. After attachment ADM to submammary fold width is measured for selection of endoprosthesis and placed in it silicone implant, then processed edge of ADM is anchored to bottom and side edges of greater pectoral muscle, upper edge of ADM pulled to lower mobilised edges of greater pectoral muscle with closing silicone implant. Further, edge of ADM is placed under greater pectoral muscle by different distances from edges of needle stick muscle and ADM, at that distance from needle stick to edge of ADM is 6 mm, and from edge of greater pectoral muscle to needle indent - 12 mm. For implementation of location of muscular tissue above leaf acellular dermal matrix edge of greater pectoral muscle and ADM connected continuous suture non-traumatic filament. Method includes separating fragment of front toothed muscle size 6-10 cm × 3 × 6 cm and mobilised fragment of front toothed muscle is moved to edge of ADM, edge of front toothed muscle and ADM by similar procedure fixation with a greater pectoral muscle musculo-matrix pocket. Then, layer by layer postoperative wound is closed with leaving vacuum drainage in silicone implant bed and in area of lymphadenectomy.

EFFECT: method reduces intraoperative injuries in single-step reconstruction owing to excluding need to use of autologous muscle grafts, reduces length of operation, widens pocket for endoprosthesis and reduces pain syndrome.

1 cl, 1 ex, 9 dwg