Evidence map›Paper›PMID 37330449›Full record

ArticleAnnals of surgical oncology2023

Air or Saline? A Propensity Score-Matched Analysis on the Effect of Tissue Expander Fill on Complications in Immediate Breast Reconstruction.

Amanda R Sergesketter, William M Tian, Brooke E Barrow, Miranda X Morris, Hannah C Langdell, Ronnie L Shammas, Yisong Geng, Kristen Rezak, Geoffroy C Sisk, Brett T Phillips

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Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 21% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Amanda R SergesketterDivision of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA.
William M TianDuke University School of Medicine, Durham, NC, USA.
Brooke E BarrowDivision of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA.
Miranda X MorrisDuke University School of Medicine, Durham, NC, USA.
Hannah C LangdellDivision of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA.
Ronnie L ShammasDivision of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA.
Yisong GengDuke Pratt School of Engineering, Durham, NC, USA.
Kristen RezakDivision of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA.
Geoffroy C SiskDivision of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA.
Brett T PhillipsDivision of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA. brett.phillips@duke.edu.
Duke University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTissue expander fill medium and volume have implications for the pressure exerted on mastectomy skin flaps. This study evaluated the influence of initial fill medium (air vs. saline) on complications in immediate breast reconstruction within a propensity score-matched cohort. PATIENTS AND

methodsPatients undergoing immediate tissue expander-based breast reconstruction with initial intraoperative fill with air were propensity score matched 1:2 to those with saline initial fill based on patient and tissue expander characteristics. Incidence of overall and ischemic complications were compared by fill medium (air vs. saline).

resultsA total of 584 patients were included, including 130 (22.2%) with initial fill with air, 377 (64.6%) with initial fill with saline, and 77 (13.2%) with 0 cc of initial fill. After multivariate adjustment, higher intraoperative fill volume was associated with increased risk of mastectomy skin flap necrosis [regression coefficient (RC) 15.7; p = 0.049]. Propensity score matching was then conducted among 360 patients (Air: 120 patients vs. Saline: 240 patients). After propensity score matching, there were no significant differences in the incidences of mastectomy skin flap necrosis, extrusion, reoperation, or readmission between the air and saline cohorts (all p > 0.05). However, initial fill with air was associated with lower incidence of infection requiring oral antibiotics (p = 0.003), seroma (p = 0.004), and nipple necrosis (p = 0.03).

conclusionsWithin a propensity score-matched cohort, initial fill with air was associated with a lower incidence of complications, including ischemic complications after nipple-sparing mastectomy. Initial fill with air and lower fill volumes may be strategies to reducing risk of ischemic complications among high-risk patients.

Indexed as

Breast ImplantsBreast NeoplasmsMammaplastyFemaleHumansMastectomyNecrosisPostoperative ComplicationsPropensity ScoreRetrospective StudiesTissue Expansion Devices

Identifiers

PMID37330449
OpenAlexW4381054564

What OpenQuestion holds

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Registered trials

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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.