A Head-to-head Comparison between SurgiMend and Epiflex in 127 Breast Reconstructions

Abstract

Background:The use of acellular dermal matrices (ADM) has become a widely used option in breast reconstruction. A great deal of literature is available, totaling over 2400 ADM reconstructions. Nonetheless, head-to-head comparisons between SurgiMend and Epiflex are not yet reported. In fact, this is the first clinical data report on the use of Epiflex. This work will, therefore, compare postoperative complication rates and costs for these ADMs.Methods:This analysis is a retrospective review of a single surgeon’s 6-year experience with both SurgiMend—an acellular bovine dermal collagen matrix for soft-tissue reconstruction and Epiflex—a decellularized human skin tissue from 2008 to 2013.Results:One hundred patients had a total of 127 implant-based reconstructions using SurgiMend (64 cases; 50.4%) or Epiflex (63 cases; 49.6%). Gross complication rates were 11.1% for SurgiMend and 40.6% for Epiflex including hematoma, postoperative skin irritation, infection, necrosis, and revision surgery. The most common complication was postoperative red breast syndrome. Severe complications requiring revision surgery were significantly increased in patients treated with Epiflex (12.5%) compared with SurgiMend (4.8%).Conclusions:This retrospective analysis favors the use of SurgiMend over Epiflex because of significantly lower gross complication rates. Severe complication rates are comparable with those reported in literature for both products. Although results promote the use of SurgiMend, the single surgeon retrospective nature of this work limits its clinical impact.

A Head to Head Comparison Between SurgiMend® – Fetal Bovine Acellular Dermal Matrix and Tutomesh® – A Bovine Pericardium Collagen Membrane in Breast Reconstruction in 45 Cases

“…Figure 3 shows a pooled analysis of complication rate data for SurgiMend ® , Epiflex ® and Tutomesh ® (10). We found complication rates to be low and comparable to literature in all cases.…”

“…Despite the assumption that ADM type may not be an independent risk factor, it remains important to compare new products to existing data. Including this work there are only 5 available publications regarding the use of SurgiMend ® , and Tutomesh ® in breast reconstruction (Table II) (8,10,16,19). Within these studies, head to head comparisons were made to AlloDerm ® and Epiflex ® ; both products based on human tissue.…”

“…antibiotics, and revision surgery (with implant loss). These endpoints are commonly used in the evaluation of ADMs (10). RBS was considered a mild, transient complication, which is often mistaken for an infection and unnecessarily treated with antibiotics although this hypersensitivity better responds to corticosteroids (11).…”

Clinical experience with Surgimend in breast reconstruction: an overview

“…Four studies reported a significant difference in complication rate between the study group treated with SurgiMend and the control group. Eichler et al (2015) reported a significantly higher incidence of infection requiring intravascular antibiotics and overall complication rate in the group treated with Epiflex vs SurgiMend. In the study by Butterfield (2013) Review © 2020 MA Healthcare Ltd statistically significant higher number of subjects treated with AlloDerm suffered from seroma (P<0.05), while subjects treated with SurgiMend showed a higher rate of minor necrosis (P<0.05).…”

Porcine‐Derived Biomaterials in Tissue Engineering and Reconstructive Surgery: Considerations and Alternatives in Muslim Patients

“…In addition, nonbiological materials such as polyglactin meshes or titanized polypropylene meshes have been used. However, several clinical studies revealed no advantages of porcine ADM over human or bovine ADMs (Ball et al, ; Butterfield, ; Eichler et al, ; Glasberg & Light, ; Mazari et al, ; Ricci et al, ). With a wide variety of choice and no clinical evidence for superiority of porcine matrices over any other, the use of porcine acellular matrices is not required for Muslim patients.…”