Inframammary Fold Reconstruction: A Biomechanical Analysis

Background: Inframammary fold reconstruction has scarcely been evaluated in literature. No biomechanical analyses have been performed comparing different reconstructive methods. This evaluation compares the gold-standard suture reconstruction with an intrarib anchor system (Micro BioComposite SutureTak, Arthrex). Methods: Three analysis groups were compared including 8 Sawbone blocks, 22 embalmed cadaver, and 27 regular cadaver specimens (N = 57). Transient mechanical analysis was performed at 5 N/s using an Instron 5565 test frame. Results: Ultimate load favored the anchor system (compared with the gold-standard suture) by a factor of 9.8 (P < 0.0001) for the regular cadaver group and a factor of 1.7 (P < 0.038) for the embalmed cadaver group. A similar statistically significant benefit was shown for stiffness and load at 2-mm displacement. Conclusions: This analysis showed an anchor system to be the biomechanically superior fixation method in terms of ultimate load, fixation stiffness, and displacement at failure when compared with the gold-standard suture method in inframammary fold reconstruction. Because of superior stability in every aspect, an anchor system may be considered for inframammary fold reconstruction.

[1]  A. Avanzini,et al.  Biomechanical Evaluation of Ascending Aortic Aneurysms , 2014, BioMed research international.

[2]  A. Seth,et al.  Reconstruction of the Inframammary Fold Using Barbed Suture , 2014, Annals of plastic surgery.

[3]  D. Dayicioğlu,et al.  The stylet technique for inframammary fold definition in breast reconstruction. , 2014, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[4]  M. Betsch,et al.  Fixation of multifragmentary patella fractures using a bilateral fixed-angle plate. , 2013, Orthopedics.

[5]  M. Betsch,et al.  Cyclic long-term loading of a bilateral fixed-angle plate in comparison with tension band wiring with K-wires or cannulated screws in transverse patella fractures , 2013, Knee Surgery, Sports Traumatology, Arthroscopy.

[6]  J. Koebke,et al.  Biomechanical cadaver testing of a fixed-angle plate in comparison to tension wiring and screw fixation in transverse patella fractures. , 2012, Injury.

[7]  D. Floyd,et al.  The use of a template to accurately position the inframammary fold in breast reconstruction. , 2011, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[8]  M. Betsch,et al.  Fixed-angle plates in patella fractures - a pilot cadaver study , 2011, European journal of medical research.

[9]  P. Jungbluth,et al.  Fixed-angle plate osteosynthesis of the patella - an alternative to tension wiring? , 2010, Clinical biomechanics.

[10]  J. Pribaz,et al.  A Simple Guide to Inframammary-Fold Reconstruction , 2005, Annals of plastic surgery.

[11]  John R Taylor.  Patient Safety in Plastic Surgery , 2004, The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique.

[12]  B. Del Frari,et al.  Inframammary fold reconstruction with a deepithelialized skin flap. , 2003, Annals of plastic surgery.

[13]  R. Silfen,et al.  "Apron" flap and re-creation of the inframammary fold following TRAM flap breast reconstruction. , 2000, Plastic and reconstructive surgery.

[14]  P. Quattrone,et al.  Focus on the Breast Fascial System: A New Approach for Inframammary Fold Reconstruction , 1998, Plastic and reconstructive surgery.

[15]  J. A. Jensen,et al.  An improved technique for creation of the inframammary fold in silicone implant breast reconstruction. , 1992, Plastic and reconstructive surgery.

[16]  Jürgen Koebke,et al.  Angle stable locking nails versus conventionally locked intramedullary nails in proximal tibial shaft fractures: a biomechanical study , 2011, Archives of Orthopaedic and Trauma Surgery.