Evidence map›Paper›PMID 33609398›Full record

Observational studyBJS open2021

Patient-reported outcomes of immediate implant-based breast reconstruction with and without biological or synthetic mesh.

E Sewart, N L Turner, E J Conroy, R I Cutress, J Skillman, L Whisker, S Thrush, N Barnes, C Holcombe, S Potter and 1 more

Abstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

E SewartPopulation Health Sciences, Bristol Centre for Surgical Research, Bristol Medical School, Bristol, UK.
N L TurnerPopulation Health Sciences, Bristol Centre for Surgical Research, Bristol Medical School, Bristol, UK.
E J ConroyLiverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK.
R I CutressCancer Sciences Unit, Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, UK.
J SkillmanDepartment of Plastic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
L WhiskerNottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham, UK.
S ThrushBreast Unit, Worcester Royal Hospital, Worcester, UK.
N BarnesNightingale Breast Unit, Manchester University NHS Foundation Trust, Manchester, UK.
C HolcombeLinda McCartney Centre, Royal Liverpool and Broadgreen University Hospital, Liverpool, UK.
S PotterPopulation Health Sciences, Bristol Centre for Surgical Research, Bristol Medical School, Bristol, UK.
implant Breast Reconstruction Evaluation (iBRA) Steering Group and the Breast Reconstruction Research Collaborative

Funding

Medical Research Council MR/K025643/1
6 · The paper itself

Abstract

backgroundBiological and synthetic meshes may improve the outcomes of immediate implant-based breast reconstruction (IBBR) by facilitating single-stage procedures and improving cosmesis. Supporting evidence is, however, limited. The aim of this study was to explore the impact of biological and synthetic mesh on patient-reported outcomes (PROs) of IBBR 18 months after surgery.

methodsConsecutive women undergoing immediate IBBR between February 2014 and June 2016 were recruited to the study. Demographic, operative, oncological and 3-month complication data were collected, and patients received validated BREAST-Q questionnaires at 18 months. The impact of different IBBR techniques on PROs were explored using mixed-effects regression models adjusted for clinically relevant confounders, and including a random effect to account for clustering by centre.

resultsA total of 1470 participants consented to receive the questionnaire and 891 completed it. Of these, 67 women underwent two-stage submuscular reconstructions. Some 764 patients had a submuscular reconstruction with biological mesh (495 women), synthetic mesh (95) or dermal sling (174). Fourteen patients had a prepectoral reconstruction. Compared with two-stage submuscular reconstructions, no significant differences in PROs were seen in biological or synthetic mesh-assisted or dermal sling procedures. However, patients undergoing prepectoral IBBR reported better satisfaction with breasts (adjusted mean difference +6.63, 95 per cent c.i. 1.65 to11.61; P = 0.009). PROs were similar to those in the National Mastectomy and Breast Reconstruction Audit 2008-2009 cohort, which included two-stage submuscular procedures only.

conclusionThis study found no difference in PROs of subpectoral IBBR with or without biological or synthetic mesh, but provides early data to suggest improved satisfaction with breasts following prepectoral reconstruction. Robust evaluation is required before this approach can be adopted as standard practice.

Indexed as

Patient Reported Outcome MeasuresSurgical MeshAdolescentAdultAgedAged, 80 and overBreast ImplantationBreast NeoplasmsFemaleHumansLinear ModelsLogistic ModelsMastectomyMiddle AgedPatient SatisfactionPostoperative Complications

Identifiers

PMID33609398
PMCPMC7896806

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.