MedWire News: Study findings suggest that postoperative breast hematoma after prosthetic implant placement occurs in less than 2% of patients, and is not associated with surgical technique, implant size, indication, or reoperation.
The findings are important, given that the incidence and risk factors associated with postoperative breast hematoma have not been fully characterized.
Breast hematomas may acutely become large enough to warrant surgical drainage and hemostatis, and remain one the most common complications along with capsular contracture and seroma formation.
"This series of patients is the largest comprehensive review of hematomas after placement of prosthetic breast implants […] it is the only study of this size to evaluate both cosmetic and reconstructive procedures," say James Collins and Charles Verheyden, both from Scott & White Healthcare in Temple, Texas, USA.
For the study, the researchers performed a retrospective analysis of 1936 operations during 1996-2008, identified from a patient medical record database. The identified procedures represented those performed by 12 surgeons, using seven incisional approaches, three anatomical breast implant locations, and four types of implants.
Over an average follow up of 48.9 months, 32 hematomas were identified following 32 operations. Breast hematomas following prosthesis implantation occurred in 1.65% of patients and at a rate of 0.92% for implants placed during the evaluated time period.
Hematomas were identified, on average, 37 days postoperatively, with most (22 of 32) diagnosed within 14 days of the procedure. Only three were identified over 30 days following surgery.
Importantly, the team found that hematomas were not significantly associated with any specific patient or surgical characteristic. No association was found for larger implant size, reoperation, operative indication, type of surgery, or implant type.
Further analysis of medications used by patients at the time of surgery showed that of the medications reported, those most likely representing a risk factor were aspirin, enoxaparin, estrogen, ibuprofen, and progesterone.
"The incidence of hematomas reported by patients in our study corresponds closely to the reported incidence in multiple other studies," say the researchers.
Combination of the existing study with nine previous ones - totaling 6542 patients - showed that the average incidence of hematomas across all studies was 2.3%.
The findings are published in the journal Plastic & Reconstructive Surgery.
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