The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary Results

Introduction: Mastectomy skin necrosis (MSN) is a common complication occurring in up to 50% of patients. In patients with risk factors for poor wound healing such as immunosuppression, prior radiotherapy (XRT), and high body mass index (BMI > 30.0), this number is even higher. MSN can lead to in...

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Main Authors: Kyle M. Ockerman, Nhan Trieu, Sabrina H. Han, Markos Mardourian, Lisa Spiguel, Kalyan Dadireddy, Sarah Sorice Virk
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Surgical Techniques Development
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Online Access:https://www.mdpi.com/2038-9582/13/3/24
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author Kyle M. Ockerman
Nhan Trieu
Sabrina H. Han
Markos Mardourian
Lisa Spiguel
Kalyan Dadireddy
Sarah Sorice Virk
author_facet Kyle M. Ockerman
Nhan Trieu
Sabrina H. Han
Markos Mardourian
Lisa Spiguel
Kalyan Dadireddy
Sarah Sorice Virk
author_sort Kyle M. Ockerman
collection DOAJ
description Introduction: Mastectomy skin necrosis (MSN) is a common complication occurring in up to 50% of patients. In patients with risk factors for poor wound healing such as immunosuppression, prior radiotherapy (XRT), and high body mass index (BMI > 30.0), this number is even higher. MSN can lead to infection, loss of reconstruction, poorer aesthetics, and most ominously, delay in adjuvant cancer therapy. Instead of forgoing reconstruction in these patients, adjunctive therapies to optimize wound healing are necessary. The purpose of this study is to introduce the use of cryopreserved umbilical tissue (vCUT) as an adjunct therapy for high-risk-wound-healing immediate breast reconstruction (IBR) patients. Methods: All patients who underwent breast reconstruction with vCUT as an adjunctive therapy were identified and retrospectively analyzed. Results: Seven patients who underwent breast reconstruction with vCUT placement were identified. These patients had risk factors for delayed healing, such as obesity, immunosuppression, and/or prior XRT. The mean post-operative follow-up was 252 days (range 183–287). Four out of seven patients demonstrated post-operative complications: two out of seven developed seromas, two out of seven developed wound dehiscence, two out of seven developed infection, two out of seven developed MSN, and two out of seven lost their reconstruction. Conclusion: As undergoing IBR leads to improved mental health and superior aesthetic outcomes, efforts to expand current indications for safe IBR to traditionally poorer reconstructive candidates are imperative. The results of this case series demonstrate vCUT as a promising novel adjunctive tool in the reconstructive surgeons’ armamentarium in managing the less ideal reconstructive breast candidate.
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spelling doaj-art-ba7ae97cc4ff44d495109d5baff3fe0d2025-08-20T01:55:52ZengMDPI AGSurgical Techniques Development2038-95822024-09-0113331332410.3390/std13030024The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary ResultsKyle M. Ockerman0Nhan Trieu1Sabrina H. Han2Markos Mardourian3Lisa Spiguel4Kalyan Dadireddy5Sarah Sorice Virk6University of Florida College of Medicine, Gainesville, FL 32610, USAUniversity of Florida College of Medicine, Gainesville, FL 32610, USADivision of Plastic and Reconstructive Surgery, University of Chicago, Chicago, IL 60637, USADivision of Plastic and Reconstructive Surgery, University of Colorado, Denver, CO 80204, USADepartment of Surgery, Division of Surgical Oncology, University of Florida, Gainesville, FL 32611, USADepartment of Surgery, Division of Plastic & Reconstructive Surgery, University of Florida, Gainesville, FL 32611, USADivision of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USAIntroduction: Mastectomy skin necrosis (MSN) is a common complication occurring in up to 50% of patients. In patients with risk factors for poor wound healing such as immunosuppression, prior radiotherapy (XRT), and high body mass index (BMI > 30.0), this number is even higher. MSN can lead to infection, loss of reconstruction, poorer aesthetics, and most ominously, delay in adjuvant cancer therapy. Instead of forgoing reconstruction in these patients, adjunctive therapies to optimize wound healing are necessary. The purpose of this study is to introduce the use of cryopreserved umbilical tissue (vCUT) as an adjunct therapy for high-risk-wound-healing immediate breast reconstruction (IBR) patients. Methods: All patients who underwent breast reconstruction with vCUT as an adjunctive therapy were identified and retrospectively analyzed. Results: Seven patients who underwent breast reconstruction with vCUT placement were identified. These patients had risk factors for delayed healing, such as obesity, immunosuppression, and/or prior XRT. The mean post-operative follow-up was 252 days (range 183–287). Four out of seven patients demonstrated post-operative complications: two out of seven developed seromas, two out of seven developed wound dehiscence, two out of seven developed infection, two out of seven developed MSN, and two out of seven lost their reconstruction. Conclusion: As undergoing IBR leads to improved mental health and superior aesthetic outcomes, efforts to expand current indications for safe IBR to traditionally poorer reconstructive candidates are imperative. The results of this case series demonstrate vCUT as a promising novel adjunctive tool in the reconstructive surgeons’ armamentarium in managing the less ideal reconstructive breast candidate.https://www.mdpi.com/2038-9582/13/3/24immediate breast reconstructioncryopreserved umbilical tissuevCUTStravixhuman placental membraneshPM
spellingShingle Kyle M. Ockerman
Nhan Trieu
Sabrina H. Han
Markos Mardourian
Lisa Spiguel
Kalyan Dadireddy
Sarah Sorice Virk
The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary Results
Surgical Techniques Development
immediate breast reconstruction
cryopreserved umbilical tissue
vCUT
Stravix
human placental membranes
hPM
title The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary Results
title_full The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary Results
title_fullStr The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary Results
title_full_unstemmed The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary Results
title_short The Use of Cryopreserved Umbilical Tissue as an Adjunctive Therapy in Immediate Breast-Reconstruction Patients at High Risk for Wound-Healing Complications: Case-Report Series and Preliminary Results
title_sort use of cryopreserved umbilical tissue as an adjunctive therapy in immediate breast reconstruction patients at high risk for wound healing complications case report series and preliminary results
topic immediate breast reconstruction
cryopreserved umbilical tissue
vCUT
Stravix
human placental membranes
hPM
url https://www.mdpi.com/2038-9582/13/3/24
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