Complications Following Expander/Implant-Based Breast Reconstruction Utilizing Acellular Dermal Matrix

Abstract

Background: The recent increase in popularity of acellular dermal matrix assistance in immediate expander/implant breast reconstruction has led to variety of viewpoints. Many studies are published indicating an increase in complications with the use of acellular dermal matrix, while others indicate there is no increase in complications. Methods: This meta-analysis utilizes information from available studies that directly compare one specific type of acellular dermal matrix with traditional methods of immediate expander/implant breast reconstruction. Eight studies were found through a meticulous literature search that met these criteria. Results: There was more than a 2-fold increase in the number of infections and explanations in the acellular dermal matrix group compared to the control. There was a 3-fold increase in seroma formation in the acellular dermal matrix group compared to the control. There was a significant difference of intraoperative fill volumes between the acellular dermal matrix group compared to the control. Conclusions: This study illustrates that after pooling all available date regarding the use of acellular dermal matrix in immediate expander/implant breast reconstruction there appears to be an increased rate of complications. However, the increased intraoperative fill volume may lead to ultimately greater patient satisfaction.

Comparison of the Amount of Drainage in 3 Acellular Dermal Matrices in Implant-Based Breast Reconstruction: A Retrospective Study

“…It is known that the degree of ADM engraftment can affect the level of inflammation, vascular permeability, encapsulation, and fibrosis. The difference in the degree of engraftment can be explained by the variability in processing and storing methods of the 3 ADM types [4,17,19,20].…”

“…It inhibits wound healing, prolongs discomfort and increases the duration of hospital visits, and sometimes leads to subsequent complications such as infection, skin necrosis, and implant failure [1,[3][4][5][6][7].…”

Muscle-Sparing ADM-Assisted Breast Reconstruction Technique Using Complete Breast Implant Coverage: A Dual-Institute UK-Based Experience

“…The advantages of single-stage reconstruction include improved lower pole projection and a better psychological impact due to single surgery [5,6]. Despite advantages, the literature reveals conflicting reports, especially in relation to postoperative complications [7,8]. Authors have reported higher rates of seroma formation and infection, while others observed no differences in the postoperative complication rates when compared to traditional expander-assisted breast reconstruction [9].…”

Biological and Synthetic Mesh Use in Reconstructive Surgery in Patients With Breast Cancer

“…The advantages of ADM are as follows: it decreases the postoperative pain syndrome intensity, prevents damage of the donor area and improves aesthetic results [36][37][38][39][40][41]. However, there are indications in medical articles about an increase in the number of postoperative infectious complications, seromas, and explantations [37,39,[43][44][45].…”

“…However, there are indications in medical articles about an increase in the number of postoperative infectious complications, seromas, and explantations [37,39,[43][44][45].…”