Evaluation of Sidestream Darkfield Microscopy for Real-Time Imaging Acellular Dermal Matrix Revascularization

DeGeorge, Brent R.; Olenczak, J. Bryce; Cottler, Patrick S.; Drake, David B.; Lin, Kant Y.; Morgan, Raymond F.; Campbell, Christopher A.

doi:10.1097/sap.0000000000000832

Cited by 4 publications

(1 citation statement)

References 31 publications

(29 reference statements)

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“…The authors report a lower incidence of major complications and delayed wound healing in the autograft group, and they contribute this in part to a 3-fold increase in the number of blood vessels per high power field in the autograft capsules. 22 Unfortunately, there is a dearth of data directly comparing the rate of blood vessel formation for the available products. We cannot comment on the rate of blood vessel formation, but we can report a similar vascular pattern and number of vessels between capsules formed in Cortiva and Alloderm grafts at an average of 7 months.…”

Section: Discussionmentioning

confidence: 99%

A Histological Comparison of Two Human Acellular Dermal Matrix Products in Prosthetic-Based Breast Reconstruction

Moyer

Hart

Yeager

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Acellular dermal matrices (ADMs) are an integral component of breast reconstruction. The ideal matrix would be relatively immuno-inert, allow rapid vascularization, and be affordable. The purpose of this study was to histologically compare 2 commonly used ADM products.Methods:This is a prospective histological study of 17 patients (20 breasts) following prosthetic-based breast reconstruction with ADM: Alloderm (LifeCell Corp, Branchburg, N.J.) or Cortiva (RTI Surgical, Alachua Fla.). Biopsies were taken from the dermal matrix and natural capsules surrounding the expander/implant during secondary surgery [Range, 72—694 days (mean, 217 days)]. Biopsy specimens were prepared via hematoxylin and eosin, Masson's trichrome, elastin, and transforming growth factor (TGF)-1 stains. Quantitative analysis of staining was performed with ImageJ software. The clinical outcome of each patient is analyzed in relation to capsule architecture and ADM performance.Results:There were 7 breasts in the Alloderm group and 13 in the Cortiva group. Both groups had similar demographic, aesthetic results, and complication profiles. The TGF-1 staining demonstrated significantly lower levels in the Cortiva capsules (P = 0.0139). The percentage of elastin and collagen are similar in the Cortiva, Alloderm, and natural peri-implant capsules. The native capsules show a significantly greater number of blood vessels when compared with Cortiva and Alloderm (P = 0.0371 and P = 0.0347, respectively); however, there is no difference in vascular pattern between the 2 dermal matrices.Discussion:Postoperatively, Cortiva demonstrates equal vascularity with less TGF-1 activation compared with Alloderm. The clinical success and complication profile were similar between the Alloderm and Cortiva patients.

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Section: Discussionmentioning

confidence: 99%