Implant-Based Breast Reconstruction Using Acellular Dermal Matrix and the Risk of Postoperative Complications

Chun, Yoon S.; Verma, Kapil Dev; Rosen, Heather; Lipsitz, Stuart; Morris, Donald J.; Kenney, Pardon R.; Eriksson, Elof

doi:10.1097/prs.0b013e3181c82d90

Cited by 449 publications

(328 citation statements)

References 7 publications

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“…This is the first study on the usage of Surgisis ® (Cook Medical, Bloomington, IN, USA), a porcine-derived acellular matrix, as an adjunct in breast reconstruction. It has been postulated that the use of matrices in breast reconstruction might increase the risk of complications as they constitute a non-vascularised material in a setting with poorly circulated mastectomy flaps [6,7]. Indeed, the total early complication rate in this study was considerably higher than that in previously published studies involving the use of biologic matrices [21].…”

Section: Discussioncontrasting

confidence: 54%

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Complications, long-term outcome and quality of life following Surgisis® and muscle-covered implants in immediate breast reconstruction: a case-control study with a 6-year follow-up

et al. 2018

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Background Matrices are now commonly used in breast reconstruction, but the scientific evidence is still scares. The main aim was to compare complications and the need for corrections in immediate breast reconstruction with the porcine-derived Surgisis ® with the traditional muscle-covered technique. The secondary aim was to compare long-term quality of life and satisfaction. Methods All consecutive patients who had their breast reconstructed with a Surgisis ® or muscle-covered tissue expander/implant were included. Patients were followed clinically and with BREAST-Q. Results During the study period, 116 reconstructions (71 patients) were operated in the Surgisis ® group and 132 reconstructions (90 patients) in the control group. The median follow-up time was 74 months (min 43-max 162). The total early complication rate was 37% in the Surgisis ® group and 27% in the control group. There were no differences in implant loss (p = 0.68) or total number of complications (p = 0.24) between the two groups. Risk factors for complications were mainly patient characteristics and the use of a tissue expander. There was a slightly higher capsular contracture frequency in the Surgisis ® patients (4.2% vs. 2.5%). The need for corrections and patient satisfaction and quality of life were similar in the two groups. Conclusions The use of Surgisis ® in implant-based reconstruction seems to result in an acceptable total early complication rate. The rate might be higher in tissue expander-based reconstruction. Risk factors are mainly patient characteristics. The capsular contracture rate and need for corrections, as well as patient satisfaction and quality of life, are similar in the Surgisis ® patients and muscle-covered controls. Level of evidence: III

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Section: Discussioncontrasting

confidence: 54%

“…Moreover, capsule formation may be less pronounced when matrices are used [2,5]. Possible drawbacks are an increased risk of complications, such as infection, skin necrosis, loss of implant and seroma formation [6,7] and a non-negligible cost [8].…”

Section: Introductionmentioning

confidence: 99%

Complications, long-term outcome and quality of life following Surgisis® and muscle-covered implants in immediate breast reconstruction: a case-control study with a 6-year follow-up

et al. 2018

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“…Using this technique, postoperative pain appears to be reduced and recovery is faster. Results are promising, with a complication rate comparable, if not superior to published series of subpectoral implant reconstruction with lower pole ADM coverage [8][9][10][12][13][14] and good aesthetic outcomes. The limited number of complications observed, despite adopting a new technique, may be explained by our previous extensive experience with the use of ADMs.…”

Section: Discussionmentioning

confidence: 48%

Pre-pectoral implant based breast reconstruction

Highton

Murphy

2017

European Journal of Surgical Oncology (EJSO)

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“…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].…”

Section: Aaps Archives Of Aesthetic Plastic Surgerymentioning

confidence: 99%

“…In patients with early-stage breast cancer, after a total skin-sparing mastectomy is conducted, the number of breast reconstructions using breast implants and acellular dermal matrix (ADM) continues to increase [1].…”

Section: Introductionmentioning

confidence: 99%

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

Kim

2017

Arch Aesthetic Plast Surg

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Background Acellular dermal matrix (ADM)-assisted breast reconstruction has gained popularity because it has several advantages. Some studies have reported that the use of ADM was strongly associated with postoperative complications, especially seroma formation. We performed direct-to-implant breast reconstruction using 3 types of human allograft products (CGDerm . The purpose of this study was to obtain information useful for the selection of an ADM product by comparing the amount of collected serum and the maintenance period of the drain. Methods Seventy-three patients with breast cancer who underwent ADM-assisted implant breast reconstruction between March 2011 and January 2016 were included in this study. The patients were divided into 3 groups based on the type of ADM that was used. The demographic characteristics collected were: age, body mass index (BMI), breast reconstruction location, smoking history, axillary dissection, comorbidities (such as hypertension and diabetes mellitus [DM]), breast implant size, breast implant type, amount of ADM, the total amount of serum that was collected in the drain, and the maintenance period of the drain. Results We obtained significant results after adjusting for variables including age, BMI, DM, axillary dissection, ADM amount, and breast implant size. Compared to AlloDerm, MegaDerm showed a significantly smaller amount of total drained serum and a significantly shorter drain maintenance period. Conclusions The use of MegaDerm led to smaller amounts of drained serum and a shorter drain maintenance period than when AlloDerm was used. In contrast, no significant differences were found between CGDerm and AlloDerm, or between CGDerm and MegaDerm.

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Implant-Based Breast Reconstruction Using Acellular Dermal Matrix and the Risk of Postoperative Complications

Cited by 449 publications

References 7 publications

Complications, long-term outcome and quality of life following Surgisis® and muscle-covered implants in immediate breast reconstruction: a case-control study with a 6-year follow-up

Complications, long-term outcome and quality of life following Surgisis® and muscle-covered implants in immediate breast reconstruction: a case-control study with a 6-year follow-up

Pre-pectoral implant based breast reconstruction

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

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