Tissue-Material Integration and Biostimulation Study of Collagen Acellular Matrices

Sierra, Lindsey Alejandra Quintero; Busato, Alice; Zingaretti, Nicola; Conti, Anita; Biswas, Reetuparna; Governa, Maurizio; Vigato, Enrico; Parodi, Pier Camillo; Bernardi, Paolo; Sbarbati, Andrea; Conti, Giamaica

doi:10.1007/s13770-021-00420-6

Cited by 10 publications

(3 citation statements)

References 34 publications

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“…The ADM used is of pig origin, it is the only one that allows complete implant coverage and that presents a three-dimensional dome shape on the anterior part which easily allocates various types and dimensions of TEs/implants without the need for time-consuming cutting and sewing required to adapt flat ADMs to curved surfaces ( 26 ). In addition, such device demonstrated adipogenic stimulation capacity, thus it is able to boost a more physiological tissue regeneration and replenishing the cells naturally present in the subcutaneous tissue ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Pre-pectoral breast reconstruction with tissue expander entirely covered by acellular dermal matrix: feasibility, safety and histological features resulting from the first 64 procedures

Bernini,

Gigliucci,

Cassetti

et al. 2024

Gland Surg

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Background Reconstructive options that can be used following conservative mastectomy, skin-, nipple-sparing and skin-reducing mastectomies, allow a remarkable variety of safe methods to restore the natural shape and aesthetics of the breast mound. In case of two-stage breast reconstruction, tissue expanders (TEs) are usually placed in a subpectoral position. The purpose of this retrospective cohort study is to evaluate the feasibility and safety of two-step reconstruction with TE in pre-pectoral position covered by acellular dermal matrix (ADM). Methods Between March 2021 and May 2023, at the Azienda Ospedaliero Universitaria Careggi, University of Florence, 55 patients with BRCA 1/2 mutations or early breast cancer underwent conservative mastectomy with immediate pre-pectoral reconstruction using TE covered with ADM, followed by a second surgery with replacement of the expander with definitive prosthesis. Demographic, oncological, and histological data along with surgical complications were recorded. Results A total of 64 conservative mastectomies were performed. In 2 patients (3.1%) complications were found that required reintervention and, in both cases, the TE had to be removed. Two patients developed hematoma and one patient developed seroma. Two patients showed wound dehiscence, both healed after conservative treatment and without implant exposure. No case of necrosis of the skin or nipple-areola complex has been observed, neither of capsular contracture. Capsule formed around TE was populated with cells and blood vessels and showed a thin area of synovial metaplasia. Conclusions In selected cases it may be more cautious to perform a two-stage breast reconstruction after radical breast surgery by means of TEs. The placement of TEs in pre-pectoral position combines the excellent aesthetic and functional results of the pre-pectoral philosophy with a quite safer and more prudent two-step approach. Our experience reports optimistic results: the ADM covering the TE is seen successfully integrating during tissue expansion and becoming a vascularised new self-tissue. Complications rates are low and such ADM-assisted two-stage pre-pectoral reconstructive technique is a safe, practical, and reproducible method.

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Section: Discussionmentioning

confidence: 99%

Pre-pectoral breast reconstruction with tissue expander entirely covered by acellular dermal matrix: feasibility, safety and histological features resulting from the first 64 procedures

Bernini,

Gigliucci,

Cassetti

et al. 2024

Gland Surg

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“…Specifically, the induction of adipogenic stimulation is morphological-dependent on the porosity, thickness, and swelling ratio of the membrane. The deposition of newly formed adipose tissue may play a key role in forming a well-organized tissue architecture around the implant [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Optimizing Acellular Dermal Matrix Integration in Heterologous Breast Reconstructive Surgery: Surgical Tips and Post-Operative Management

Caputo,

Scarabosio,

Di Filippo

et al. 2023

Medicina

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Background and Objective: Prepectoral implant placement in breast reconstruction is currently a must-have in the portfolios of breast surgeons. The introduction of new tools and conservative mastectomies is a game changer in this field. The prepectoral plane usually goes hand-in-hand with the ADM wrapping of the implant. It is a cell-free dermal matrix comprising a structurally integrated basement membrane complex and an extracellular matrix. The literature reports that ADMs may be useful, but proper patient selection, surgical placement, and post-operative management are essential to unlock the potential of this tool, as these factors contribute to the proper integration of the matrix with surrounding tissues. Materials and Methods: A total of 245 prepectoral breast reconstructions with prostheses or expanders and ADMs were performed in our institution between 2016 and 2022. A retrospective study was carried out to record patient characteristics, risk factors, surgical procedures, reconstructive processes, and complications. Based on our experience, we developed a meticulous reconstruction protocol in order to optimize surgical practice and lower complication rates. The DTI and two-stage reconstruction were compared. Results: Seroma formation was the most frequent early complication (less than 90 days after surgery) that we observed; however, the majority were drained in outpatient settings and healed rapidly. Secondary healing of wounds, which required a few more weeks of dressing, represented the second most frequent early complication (10.61%). Rippling was the most common late complication, particularly in DTI patients. After comparing the DTI and two-stage reconstruction, no statistically significant increase in complications was found. Conclusions: The weakness of prepectoral breast reconstruction is poor matrix integration, which leads to seroma and other complications. ADM acts like a graft; it requires firm and healthy tissues to set in. In order to do so, there are three key steps to follow: (1) adequate patient selection; (2) preservative and gentle handling of intra-operative technique; and (3) meticulous post-operative management.

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“…While the latter may provide a satisfying workaround for certain applications, it is not readily available to a wider range of researchers working with rodents. Quintero Sierra et al (2022) further analyzed properties of 3 different subcutaneously injected acellular membranes in 30 rats, and had to perform tedious pixel-by-pixel manual volume segmentation in all animals. More recently, Tawagi et al (2023) studied different hydrogel discs injected dorsally in 8 rats, using inhouse threshold-based MATLAB scripts for implant segmentation.…”

Section: Introductionmentioning

confidence: 99%

Automated segmentation and labeling of subcutaneous mouse implants at 14.1T

Adda,

Bioley,

Van De Ville

et al. 2023

Front. Signal Process.

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Magnetic resonance imaging (MRI) is a valuable tool for studying subcutaneous implants in rodents, providing non-invasive insight into biomaterial conformability and longitudinal characterization. However, considerable variability in existing image analysis techniques, manual segmentation and labeling, as well as the lack of reference atlases as opposed to brain imaging, all render the manual implant segmentation task tedious and extremely time-consuming. To this end, the development of automated and robust segmentation pipelines is a necessary addition to the tools available in rodent imaging research. In this work, we presented and compared commonly used image processing contrast-based segmentation approaches—namely, Canny edge detection, Otsu’s single and multi-threshold methods, and a combination of the latter with morphological operators—with more recently introduced convolutional neural network (CNN-) based models, such as the U-Net and nnU-Net (“no-new-net”). These fully automated end-to-end state-of-the-art neural architectures have shown great promise in online segmentation challenges. We adapted them to the implant segmentation task in mice MRI, with both 2D and 3D implementations. Our results demonstrated the superiority of the 3D nnU-Net model, which is able to robustly segment the implants with an average Dice accuracy of 0.915, and an acceptable absolute volume prediction error of 5.74%. Additionally, we provide researchers in the field with an automated segmentation pipeline in Python, leveraging these CNN-based implementations, and allowing to drastically reduce the manual labeling time from approximately 90 min to less than 5 min (292.959 s ± 6.49 s, N = 30 predictions). The latter addresses the bottleneck of constrained animal experimental time in pre-clinical rodent research.

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Tissue-Material Integration and Biostimulation Study of Collagen Acellular Matrices

Cited by 10 publications

References 34 publications

Pre-pectoral breast reconstruction with tissue expander entirely covered by acellular dermal matrix: feasibility, safety and histological features resulting from the first 64 procedures

Pre-pectoral breast reconstruction with tissue expander entirely covered by acellular dermal matrix: feasibility, safety and histological features resulting from the first 64 procedures

Optimizing Acellular Dermal Matrix Integration in Heterologous Breast Reconstructive Surgery: Surgical Tips and Post-Operative Management

Automated segmentation and labeling of subcutaneous mouse implants at 14.1T

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