Insorb Stapler in Reduction Mammoplasty: Outcomes, Quality-of-Life, & Aesthetics
Viren Patel1, Jason Green2, Adrienne Christopher3, Martin Morris4, Robyn Broach5, Paris Butler6
University of Pennsylvania, Philadelphia, PA
Introduction Reduction mammaplasty is a mainstay in the treatment of macromastia, with a marked impact on patient quality-of-life (QoL). However, this procedure requires closure of long incisions, which can increase operative time, and therefore, utilize precious healthcare resources. The Insorb stapler has been employed to improve efficiency of incision closure, but it is unclear what effect its use has on key outcomes after reduction mammoplasty. Here, we determine how use of the Insorb affects clinical outcomes, QoL, and cosmetic appearance after reduction mammoplasty. Method(s) A retrospective review was conducted of patients undergoing reduction mammoplasty between November 2018 and October 2020 with a single surgeon. Patients were split into two cohorts based on method of dermal skin closure: Insorb stapler and suture closure. Data, including patient demographics, operative information, clinical outcomes, and QoL, as measured by the BREAST-Q, were collected. A subset of patient photos taken at 3-month follow-up (20 Insorb & 20 suture) were evaluated by panel of independent raters, utilizing a modified version of the Aesthetic Items Scale. Categorical and continuous outcomes data was compared using X2 tests and Wilcoxon Rank Sum tests. Aesthetic ratings were compared using t-tests. Result:s 78 patients met the inclusion criteria, with 35 patients (46%) in the Insorb group. While the total breast mass removed was similar between the groups (Insorb: 1792 vs. Suture: 1583 grams; p=0.10), total procedure time was significantly reduced with the use of the Insorb stapler (Insorb: 154 vs. Suture: 170 minutes; p=0.002). Composite complication rates were similar between the groups with 17 (49%) and 18 (44%) patients in the Insorb and suture cohorts developing a complication, respectively (p=0.68). There were no significant differences between the cohorts in terms of T-point breakdown or delayed healing (both p>0.05). Regardless of closure technique, patients demonstrated significant increases in all QoL domains (p0.05). Finally, 10 independent raters found no difference in the cosmetic appearance of breasts from either cohort, when judging overall appearance, shape, scars, volume or the nipple-areolar complex (all p>0.05). Conclusion: The Insorb stapler can improve efficiency of incision closure during reduction mammoplasty without increasing incidence of wound healing complications and yielding similar quality of care outcomes.
Back to 2021 Abstracts