Prepectoral Implant-Based Breast Reconstruction Using Meshed ADM

Fin, Alessandra; Biasio, Fabrizio De; Mura, Sebastiano; Massarut, Samuele; Zaccaria, Giovanna; Parodi, Pier Camillo

doi:10.1177/2292550320933687

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…Studies currently available on PPBR and fenestrated ADMs seem to confirm this hypothesis. Compared with 2.1% CC incidences reported in the iBAG study ( 53 ) and the weighted mean of 2.06% in this study, which is calculated with the Braxon® continuous collagen sheet, fenestrated-ADM-assisted PPBRs outline higher CC incidences: out of 71 breasts, Scheflan et al found an incidence rate of 8.5% of CC ( 119 ), while in the same year, Fin et al recorded 6% ( 120 ). More recently, Wazir et al reported a 12.5% incidence rate ( 121 ).…”

Section: Discussioncontrasting

confidence: 60%

Braxon®-assisted prepectoral breast reconstruction: A decade later

et al. 2022

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We are sitting on the cusp of the bioengineered breast era, in which implant-based breast reconstruction is seeing a growing trend and biotechnology research progressively empowers clinical practice. As never before, the choice of biomaterials has acquired great importance for achieving reconstructive outcomes, and the increase in the use of acellular dermal matrices (ADMs) in the field of senology tells us a story of profound upheaval and progress. With the advent of prepectoral breast reconstruction (PPBR), plenty of devices have been proposed to wrap the silicone prosthesis, either completely or partially. However, this has caused a great deal of confusion and dissent with regard to the adoption of feasible reconstructive strategies as well as the original scientific rationale underlying the prepectoral approach. Braxon® is the very first device that made prepectoral implant positioning possible, wrapping around the prosthesis and exerting the proven ADM regenerative potential at the implant–tissue interface, taking advantage of the body's physiological healing mechanisms. To date, the Braxon® method is among the most studied and practiced worldwide, and more than 50 publications confirm the superior performance of the device in the most varied clinical scenarios. However, a comprehensive record of the working of this pioneering device is still missing. Therefore, our aim with this review is to lay a structured knowledge of surgery with BRAXON® and to provide a decision-making tool in the field of PPBR through a complete understanding on the very first device for prepectoral, one decade after its introduction.

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Section: Discussioncontrasting

confidence: 60%

Braxon®-assisted prepectoral breast reconstruction: A decade later

et al. 2022

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“…Mean/median age ranged from 34.2 years 13 to 56.4 years. 14 Average follow-up was reported from 12 months 15 to 5 years. 16 The main study characteristics are summarized in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

The Failed Breast Implant in Postmastectomy Reconstruction

Bucher

Vogt²

2022

Ann Plast Surg

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BackgroundBreast cancer is the most diagnosed malignant neoplasia of female patients worldwide in 2019. Survival has increased making it necessary to offer breast reconstructive procedures to improve quality of life and self-esteem. Implant-based breast reconstruction is the most common approach, making it necessary to quantify the associated complications.MethodsA systematic literature review of the PubMed, Cochrane, and Web of Science databases was performed. A total of 9608 citations were identified, and 44 studies met the inclusion criteria.ResultsStudies included reported the incidence of complications either per patient or per breast leading consequently to 2 complication rates depending on the type of reporting. A total of 14.3% of patient-related and 28.8% of breast-related complications while undergoing implant-based reconstruction were reported.Among total complications reported, 72.6% of patient-related and 48.5% of breast-related complications were classified as major complications.A total of 37.6% of patients respectively 15.1% of breasts required prosthesis explantation due to severe complications. Depending on reporting, 9.7% of patients and 4% of breasts required autologous flap reconstruction due to reconstructive failure.ConclusionsHigh complication and failure rates are associated with implant-based breast reconstruction. Lacking randomized controlled trials, the choice between implant-based and autologous breast reconstruction has to be made individually for each patient.

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“…Four different reviewers performed title and abstract review. Full-text review was conducted for 355 articles; 33 studies were eligible and underwent data extraction 16,17,29–62 (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Comparison of Human, Porcine, and Bovine Acellular Dermal Matrix in Prepectoral Breast Reconstruction

et al. 2022

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The aim of the study is to determine rates of overall complications and failure of prepectoral breast reconstruction between various types of acellular dermal matrices (ADMs). Background: Implant-based breast reconstruction is the most common reconstructive technique after mastectomy in the United States. Traditionally, the reconstruction has been performed in the subpectoral plane; however, there has been an emerging interest in prepectoral reconstruction using ADM. Human (hADM), porcine (pADM), and bovine (bADM) ADMs are available for use, but little is known about the benefits and complication profiles of each for prepectoral breast reconstruction. Methods: Studies examining complications after the use of ADM for prepectoral breast reconstruction were identified using MEDLINE, Embase, the Cochrane Library, LILACS, and the Web of Science from January 2010 to August 2021. Titles and abstracts of 1838 studies were screened, followed by full-text screening of 355 articles. Thirty-three studies were found to meet inclusion criteria. Results: From the 33 studies, 6046 prepectoral reconstructions were examined. Implant loss was comparable across the different types of ADM (pADM, 4.0%; hADM, 4.0%; bADM, 3.7%). Bovine ADM had the highest rate of capsular contracture (6.1%), infection (9.0%), skin flap necrosis (8.3%), dehiscence (5.4%), and hematoma (6.1%) when compared with both hADM and pADM. Human ADM had the highest rate of postoperative seroma (5.3%), followed by pADM (4.6%) and bADM (4.5%). Conclusions: Among the prepectoral breast reconstruction studies using hADM, pADM, or bADM included in our analysis, complication profiles were similar. Bovine ADM had the highest proportion of breast complications in the following categories: capsular contracture, infection rate, skin flap necrosis, dehiscence, and hematoma. Implant loss was comparable across the cohorts. Overall, prepectoral breast reconstruction using ADM leads to relatively low complication rates with the highest rates within the bADM cohort.

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Prepectoral Implant-Based Breast Reconstruction Using Meshed ADM

Cited by 10 publications

References 16 publications

Braxon®-assisted prepectoral breast reconstruction: A decade later

Braxon®-assisted prepectoral breast reconstruction: A decade later

The Failed Breast Implant in Postmastectomy Reconstruction

Comparison of Human, Porcine, and Bovine Acellular Dermal Matrix in Prepectoral Breast Reconstruction

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