Reducing Postoperative Infections and Red Breast Syndrome in Patients With Acellular Dermal Matrix–Based Breast Reconstruction

Abstract

According to our study, sterile AlloDerm has a clinically decreased incidence of complications compared to aseptic AlloDerm. Whereas RBS decreased, it was interesting to see that it was not eliminated altogether. This suggests that the etiology may be unrelated to ADM processing and warrants further investigation. Overall, the most notable difference was the statistically significant decrease in the total complication rate. Therefore, the change to sterile AlloDerm seems to be beneficial. Further benefit arises from ease of preparation in the operating room.

Complication Rates With Human Acellular Dermal Matrices: Retrospective Review of 211 Consecutive Breast Reconstructions

“…For example, although some authors have argued over the effect of graft sterility on infection rates, 14,24 it is noteworthy that the lowest infection rate of the 4 HADMs included in this study was associated with the only terminally, device-level (sterile assurance level 10 −6 ) sterile product (hMatrix), and the highest infection rate was associated with a nonsterile, aseptically processed product (FlexHD, Musculoskeletal Transplant Foundation (MTF); Edison, N.J.). Furthermore, Alloderm RTU (LifeCell Corporation; Bridgewater, N.J.), although provided sterile (SAL 10 −3 ), had the highest total complication rate (31.6%) of the 4 HADMs studied, which, in part, is hypothesized to be a result of immunogenicity issues with the preservatives in the product packing solution.…”

Volume replacement with diced acellular dermal matrix in oncoplastic breast-conserving surgery: a prospective single-center experience

“…When using ADM, inflammation without infection is called RBS and has been reported in 1.7-6% of cases [11][12][13]. RBS is a delayed-type hypersensitivity reaction [14,15].…”

Nummular eczema of the breast following surgery and reconstruction in breast cancer patients

“…The differential diagnosis also includes RBS, a noninfectious, erythematous rash generally described with acellular dermal matrix (ADM) use in breast reconstruction [8]. RBS tends to occur days to weeks following reconstruction, improves spontaneously or with corticosteroids [8], and decreases in frequency if ADM is adequately rinsed before use [9]. Given the time course, RBS is often confused for cellulitis, though clinical features of infection are absent and erythema is unresponsive to antibiotics [10].…”