Transplant of an Autologous Platelet Gel Prosthesis to Fill Defects After Tumor Excision

• Published in: Annals of plastic surgery Vol. 72; no. 4; pp. 381 - 387
• Main Authors: Serra-Renom, Jose M, Cabero, Guillem, Serra-Mestre, Jose Maria, D’Andrea, Francesco, Marco, Vicente, Mayo, Wenceslao
• Format: Journal Article
• Language: English
• Published: United States by Lippincott Williams & Wilkins 01-04-2014
• Subjects: Aged; Blood Platelets; Breast Implantation - methods; Breast Implants; Breast Neoplasms - surgery; Carcinoma, Ductal, Breast - surgery; Carcinoma, Intraductal, Noninfiltrating - surgery; Female; Gels; Humans; Mastectomy, Segmental; Middle Aged; Phyllodes Tumor - surgery; Treatment Outcome
• ISSN: 0148-7043; 1536-3708
• DOI: 10.1097/SAP.0b013e3182610b4d

BACKGROUNDTumor excision causes disfigurement in the breast. We present our technique for filling the defect with activated platelet gel, thus avoiding the deformity.
METHODSBetween 2006 and 2011, 23 patients (age range, 45–72 years) underwent tumorectomy for breast cancer. After estimating and extracting the volume of blood required, we centrifuged the blood at 1800 rpm for 8 minutes. Later, the middle and lower thirds of the plasma) were separated and activated with CaCl2 at a ratio of 1/20, forming a gel, which was used to fill the tumorectomy cavity.
RESULTSImaging tests (ultrasound, mammography, and magnetic resonance imaging) performed 12 months after surgery revealed scar tissue in the area where the autoprosthesis had been inserted. Magnetic resonance imaging showed no retraction or deformity in the skin silhouette. Histology study after 1 year demonstrated that the platelet gel had been replaced by fibrous scar tissue with dense collagen and the presence of small capillary vessels. Patients recorded high rates of satisfaction.
CONCLUSIONSThis technique maintains the shape and volume of the breast, avoiding deformities and retractions of the nipple areola complex by filling the defect with an autoprosthesis. After 12 months, the autoprosthesis had been replaced by fibrous tissue and dense collagen. Postoperative control was good, and the effectiveness of adjuvant radiotherapy or chemotherapy was not altered. No cases of tumor relapse were recorded. On palpation, consistency and softness were similar to that of breast tissue. The aesthetic results were highly satisfactory.