Quantity of Acellular Dermal Matrix in Immediate Breast Reconstruction and Outcomes

Driscoll, Cassandra R.; Prabhu, Shamit S.; Davidson, Amelia L.; Katz, Adam J.

doi:10.1097/sap.0000000000003121

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…10,11 A dose-response relationship has been described in the inclusion of ADM in immediate breast reconstruction, with increased quantities of ADM demonstrating significantly higher odds of infectious complications. 30 Meshing of ADM reduces the overall quantity of ADM used and can therefore reduce the infection risk. It is possible that aseptic ADM use could be to blame for higher reported infection rates in ADM-based reconstruction, as studies rarely account for sterility as a potential confounder.…”

Section: Discussionmentioning

confidence: 99%

Early Complications after Prepectoral Tissue Expander Placement in Breast Reconstruction with and without Acellular Dermal Matrix

Pires

Marquez

Memmott

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Prepectoral breast reconstruction has become popularized with the concurrent use of acellular dermal matrix (ADM). The authors sought to compare 3-month postoperative complication rates and explantation rates for first-stage, tissue-expander-based, prepectoral breast reconstruction with and without the use of ADM. Methods: A single-institution retrospective chart review was performed to identify consecutive patients undergoing prepectoral tissue-expander-based breast reconstruction from August of 2020 to January of 2022. Chi-square tests were used to compare demographic categorical variables, and multiple variable regression models were used to identify variables associated with 3-month postoperative outcomes. Results: The authors enrolled 124 consecutive patients. Fifty-five patients (98 breasts) were included in the no-ADM cohort and 69 patients (98 breasts) were included in the ADM cohort. There were no statistically significant differences between the ADM and no-ADM cohorts with regard to 90-day postoperative outcomes. On multivariable analysis, there were no independent associations between seroma, hematoma, wound dehiscence, mastectomy skin flap necrosis, infection, unplanned return to the operating room, or explantation in the ADM and no-ADM groups after controlling for age, body mass index, history of diabetes, tobacco use, neoadjuvant chemotherapy, and postoperative radiotherapy. Conclusions: The authors' results reveal no significant differences in odds of postoperative complications, unplanned return to the operating room, or explantation between the ADM and no-ADM cohorts. More studies are needed to evaluate the safety of prepectoral, tissue expander placement without ADM.

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Section: Discussionmentioning

confidence: 99%

Early Complications after Prepectoral Tissue Expander Placement in Breast Reconstruction with and without Acellular Dermal Matrix

Pires

Marquez

Memmott

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…Acute infections occur immediately after surgery and have the clinical signs of cellulitis [67], while subacute and late infections occur months to years after surgery and are usually clinically occult [68]. An increased infection rate is reported with the auxilliary use of ADMs that is even higher in respect to ADM burden [69]. Infection is usually manifested with a peri-implant effusion, while on MRI the capsule may present thickening and contrast enhancement (Figure 7).…”

Section: Infectionmentioning

confidence: 99%

Imaging of the Reconstructed Breast

Kanavou,

Mastorakos,

Mastorakos

et al. 2023

Preprint

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The incidence of breast cancer and therefore need for breast reconstruction is expected to increase. The many reconstructive options available and the changing aspects of the field make this a complex area of plastic surgery, requiring knowledge and expertise. Two major types of breast reconstruction can be distinguished: Breast Implants and Autologous Flaps. Both present advantages and disadvantages. Autologous fat grafting is also commonly used. MRI is the modality of choice for evaluating breast reconstruction. Knowledge of the type of reconstruction is preferable to provide the maximum of pertinent information and avoid false positives. Early complications include seroma, hematoma, and infection. Late complications depend on the type of reconstruction. Implant rupture and implant capsular contracture are frequently encountered. Depending on the implant type, specific MRI signs can be depicted. In case of myocutaneous flap, fat necrosis, fibrosis and vascular compromise represent the most common complications. Late cancer recurrence is much less common. Rare reported late complications include breast implant associated large cell anaplastic lymphoma (BIA-ALCL) and, recently described and even rarer, Breast implant-associated squamous cell carcinoma (BIA-SCC). In this review article, the various types of breast reconstruction will be presented, with emphasis on pertinent imaging findings and complications.

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Section: Infectionmentioning

confidence: 99%

Imaging of the Reconstructed Breast

Kanavou,

Mastorakos,

Mastorakos

et al. 2023

Diagnostics

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The incidence of breast cancer and, therefore, the need for breast reconstruction are expected to increase. The many reconstructive options available and the changing aspects of the field make this a complex area of plastic surgery, requiring knowledge and expertise. Two major types of breast reconstruction can be distinguished: breast implants and autologous flaps. Both present advantages and disadvantages. Autologous fat grafting is also commonly used. MRI is the modality of choice for evaluating breast reconstruction. Knowledge of the type of reconstruction is preferable to provide the maximum amount of pertinent information and avoid false positives. Early complications include seroma, hematoma, and infection. Late complications depend on the type of reconstruction. Implant rupture and implant capsular contracture are frequently encountered. Depending on the implant type, specific MRI signs can be depicted. In the case of myocutaneous flap, fat necrosis, fibrosis, and vascular compromise represent the most common complications. Late cancer recurrence is much less common. Rarely reported late complications include breast-implant-associated large cell anaplastic lymphoma (BIA-ALCL) and, recently described and even rarer, breast-implant-associated squamous cell carcinoma (BIA-SCC). In this review article, the various types of breast reconstruction will be presented, with emphasis on pertinent imaging findings and complications.

show abstract

Quantity of Acellular Dermal Matrix in Immediate Breast Reconstruction and Outcomes

Cited by 4 publications

References 24 publications

Early Complications after Prepectoral Tissue Expander Placement in Breast Reconstruction with and without Acellular Dermal Matrix

Early Complications after Prepectoral Tissue Expander Placement in Breast Reconstruction with and without Acellular Dermal Matrix

Imaging of the Reconstructed Breast

Imaging of the Reconstructed Breast

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