Immediate Single Stage Implant-based Breast Reconstruction with or Without TIGR Mesh in Iranian Patients Undergoing Mastectomy: A Quasi-experimental Study

Abstract

Background: Breast cancer is still a major contributing factor to the burden of the disease worldwide. A single-stage implant-based reconstruction (IBR) lowers tissue morbidity, thus increasing overall aesthetic outcome and patient satisfaction. Objectives: Because of the high price of ADM and the lack of insurance coverage in Iran, we aimed at examining the results of using TIGR® mesh in patients with breast cancer. Methods: This quasi-experimental study was conducted in Iran (Tehran) from 2016 to 2018. About 140 eligible patients with breast cancer were included and their information was collected and analyzed prospectively during the 3 years that they were referred to the surgery center in Tehran. The reconstruction was performed, as either direct-single staged, Implant + TIGR MESH, or delayed-multistage. Patient satisfaction was calculated after 1 year of follow-up, using Body Checking Questionnaire (BCQ) by applying the VAS scale. All statistical analyses were performed at a 95% significance level, using SPSS statistical software version. (Evidence-based medicine level: Level III, a prospective cohort). Results: The results of our study showed slightly more short-term complications than other studies due to the surgical team’s first experience in the surgery. Complications were infection (7.1%), epidermal necrosis (15.9%), and severe capsular contracture (14.2%). Seven patients (6.2%) had full-thickness skin necrosis, and the prosthesis was finally removed. The use of the TIGR Mesh did not increase the rate of complications, and only 5 implant losses in this group and 2 in the tissue expander group were reported. The levels of patients’ satisfaction in IBR and delayed-multistage groups were 44.4% and 12.7%, respectively. Conclusions: Our results showed that placement of TIGR MESH for lower pole support during IBR does not increase the complication rate. Additionally, patients’ satisfaction levels increased compared to traditional methods of reconstruction.