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KMID : 1037020170060010005
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Medical Lasers; Engineering, Basic Research, and Clinical Application
2017 Volume.6 No. 1 p.5 ~ p.9
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Application of Nipple-Areolar Complex Impending Necrosis with Light-Emitting Diode Treatment for Immediate Breast Reconstruction after Nipple-Sparing Mastectomy
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Yoon Seok-Min
Park Yu-Gil
Park Eun-Soo
Choi Chang-Yong
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Abstract
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Background and Objectives: Necrosis of the nipple-areolar complex (NAC) is a devastating complication of reconstructive breast surgery. Noncontact, Light-emitting diode (LED) phototherapy is an attractive therapy that promotes wound healing by stimulating the fibroblasts and increasing cell activities of the wound bed. We investigated the clinical efficacy of LED phototherapy to minimize nipple-areolar complex necrosis after nipple-sparing mastectomy with immediate breast reconstruction.
Materials and Methods: Then patients received LED phototherapy. OMEGA Light® (Esmedi global, Seoul, Korea) has 4 different wavelengths that ranged from 423 nm to 640 nm. A 640 nm LED red light source was used. Patients received LED phototherapy for 20 minutes, twice a day, until postoperative week one. To reduce bacterial contamination and promote quick granulation and reepithelization, wound dressings were changed twice a day after phototherapy.
Results: Patients at risk of NAC ischemia showed clinical signs, including discoloration, edema of the nipple, and altered capillary refilling within the first 24 hours. Although NAC appeared to be ischemic and started to demarcate in the early postoperative period, there were no significant tissue loss. All ischemic NACs healed by secondary intention. Despite the presence of some demarcated areas in the early postoperative period, natural-looking NACs were restored in all breasts.
Conclusion: The use of LED inducing a photobiomodulative reaction to ischemic NACs after breast reconstruction can be effective in reducing postoperative NAC full thickness necrosis and improving wound healing.
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KEYWORD
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LED, NAC, Nipple sparing mastectomy, Reconstruction of breast
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