Comparison of Histological Characteristics of Acellular Dermal Matrix Capsules to Surrounding Breast Capsules in Acellular Dermal Matrix–Assisted Breast Reconstruction

Yu, Deborah; Hanna, Kasandra R.; LeGallo, Robin D.; Drake, David B.

doi:10.1097/sap.0000000000000368

Cited by 25 publications

(19 citation statements)

References 16 publications

(25 reference statements)

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“…In this study, the reading pathologists were blinded, which lends additional credibility to these findings. 20 Leong et al further supported the theory that ADMs limit capsular formation by showing decreased inflammatory changes, fibroblast activity, collagen I deposition, and capsular fibrosis in Allo-Derm capsule samples. 21 Besides the benefits of decreased incidence of CC, ADMbased approaches also provide superior control of inframammary fold positioning compared with alternative techniques.…”

Section: Advantages Of Acellular Dermal Matrix Usementioning

confidence: 86%

Evidence for the Use of Acellular Dermal Matrix in Implant-Based Breast Reconstruction

Gravina

Pettit

Davis

et al. 2019

Seminars in Plastic Surgery

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Acellular dermal matrices (ADMs) are tissue grafts that have been specially processed to remove all cellular components. These machined biological scaffolds have become popular in a variety of surgical settings due to their rapid incorporation into living tissue. As ADMs are highly malleable and cause minimal inflammation, they have come to serve as a useful tool in implant-based breast reconstruction procedures. The major benefits of using an ADM in this setting include superior initial breast contouring, decreased risk of capsular contracture after implant insertion, and consistent sustained positioning of the reconstructed breast. Despite these advantages, these tissue grafts are foreign to the host, and postoperative complications following ADM insertion, including infection and seroma, have been well documented. When considering using ADMs in this setting, it is important to first consider patient-specific factors that could preclude their use, such as low body mass index, small breasts, or a history of radiation exposure to the breast tissue. ADM grafts are also expensive, which may present another barrier to their use. Review of the literature ultimately suggests a continued role for ADMs in implant-based breast reconstruction, and continued research in this field is warranted.

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Section: Advantages Of Acellular Dermal Matrix Usementioning

confidence: 86%

Evidence for the Use of Acellular Dermal Matrix in Implant-Based Breast Reconstruction

Gravina

Pettit

Davis

et al. 2019

Seminars in Plastic Surgery

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“…It also plays a pivotal role in tissue morphogenesis and organ development, thus providing the most suitable environment for the cells [7][8][9]. Through physical, chemical and biochemical methods, dECM is prepared by preserving the basic structural and functional ECM proteins of tissue and removing the cellular components that might cause immune rejection or inflammatory responses [10][11][12]. Although various studies have been focused on 3D constructs based on the use of dECM, there is a general lack of research on changes in gene expression within the 3D construct.…”

Section: Introductionmentioning

confidence: 99%

A potential dermal substitute using decellularized dermis extracellular matrix derived bio-ink

Won¹,

Lee²,

Kim³

et al. 2019

Artificial Cells, Nanomedicine, and Biotechnology

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Upon bioprinting, cells are mixed with a biomaterial to fabricate a living tissue, thus emphasizing the importance of biomaterials. The biomaterial used in this study was a bio-ink prepared using skin decellularized extracellular matrix (dECM). Skin dECM was extracted by treating the dermis with chemicals and enzymes; the basic structural and functional proteins of the ECM, including collagen, glycosaminoglycans (GAGs), bioreactive materials and growth factors, were preserved, whereas the resident cells that might cause immune rejection or inflammatory responses were removed. The bio-ink based on dECM powder, together with human dermal fibroblasts (HDFs), was loaded into the nozzle of the 3D bioprinter to create the 3D construct. This construct underwent gelation with changing temperature while its shape was maintained for 7 days. The cells showed over 90% viability and proliferation. By analysing the gene expression pattern in the cells of the construct, the skin regenerative mechanism of the bio-ink was verified. Microarray results confirmed that the gene expression related to skin morphology and development had been enhanced because the bioreactive molecules and growth factors, in addition to residual ECM in dECM, provided an optimal condition for the HDFs.

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“…One of the stated advantages of meshes is that they might impede capsule formation around implants and thereby diminish the risk of capsular contracture [10]. The theory is that meshes might decrease the inflammatory response [11][12][13][14]. Evidence of a decreased inflammation has been seen in histological studies were inflammatory markers in biopsies from the integrated mesh and the native subpectoral pocket have been compared [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…The theory is that meshes might decrease the inflammatory response [11][12][13][14]. Evidence of a decreased inflammation has been seen in histological studies were inflammatory markers in biopsies from the integrated mesh and the native subpectoral pocket have been compared [11][12][13]. The diminished inflammatory response could be explained by that the retained extracellular matrix proteins in biological meshes facilitate wound healing [15], which implies that the process might be different in biological and synthetic meshes.…”

Section: Introductionmentioning

confidence: 99%

Comparison of inflammatory response and synovial metaplasia in immediate breast reconstruction with a synthetic and a biological mesh: a randomized controlled clinical trial

Hansson

Burian

Hallberg

2019

Journal of Plastic Surgery and Hand Surgery

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The aim of this study was to compare inflammatory response and synovial metaplasia in implant-based immediate breast reconstruction with a biological mesh (Veritas V R) with that of a synthetic mesh (TIGR V R Matrix Surgical Mesh). We hypothesize that the inflammatory response and formation of synovial metaplasia might be different and the rate of capsular contracture therefore different. The patients were recruited from the Gothenburg TIGR V R /Veritas V R Study (ClinicalTrials.Gov identifier NCT02985073). All referrals for bilateral immediate breast reconstruction were assessed for inclusions. During the operation, the patients were randomized to which sides the biological and the synthetic mesh were going to be applied. During the implant exchange biopsies were taken. Biopsies were taken from 30 breasts in 15 patients. There seem to be more myofibroblast and neovascularization in the biological meshes than in the synthetic and the collagen fibers seem to be aligned in an irregular pattern with both parallel and vertical fibers. In the synthetic meshes, there were more giant cells and foreign body reaction and the collagen fibers were loosely and well aligned, oriented parallel to the surface of the implant. Synovial metaplasia was seen in the majority of both the biological and the synthetic meshes. The histological patterns in early capsules from biological and synthetic meshes vary considerably. Nonetheless, it is unknown what role different cell types have in capsular formation in the long run and there was no difference in clinical capsular contracture at the clinical follow-up in this study.

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Comparison of Histological Characteristics of Acellular Dermal Matrix Capsules to Surrounding Breast Capsules in Acellular Dermal Matrix–Assisted Breast Reconstruction

Cited by 25 publications

References 16 publications

Evidence for the Use of Acellular Dermal Matrix in Implant-Based Breast Reconstruction

Evidence for the Use of Acellular Dermal Matrix in Implant-Based Breast Reconstruction

A potential dermal substitute using decellularized dermis extracellular matrix derived bio-ink

Comparison of inflammatory response and synovial metaplasia in immediate breast reconstruction with a synthetic and a biological mesh: a randomized controlled clinical trial

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