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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(02): 166-173
DOI: 10.1055/s-0042-1744408
Breast/Trunk
Case Report

Meshed Acellular Dermal Matrix for Two-Staged Prepectoral Breast Reconstruction: An Institutional Experience

Authors

  • Jessica Luo‡   *

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah

  • Rhett N. Willis Jr‡   *

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah

  • Suzanna M. Ohlsen

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah

  • Meghan Piccinin

    2   Michigan State University College of Osteopathic Medicine, East Lansing, Michigan

  • Neal Moores

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah

  • Alvin C. Kwok

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah

  • Jayant P. Agarwal

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah
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Abstract

The introduction of acellular dermal matrix (ADM) to breast reconstruction has allowed surgeons to reexplore the prepectoral implant placement technique in postmastectomy breast reconstruction. Our institution adopted a novel approach using meshed ADM to lessen the financial burden of increased ADM utilization with the prepectoral breast reconstruction. This is a retrospective, single-center review of two-stage prepectoral breast reconstruction using meshed human-derived ADM for anterior prosthesis coverage. Patient demographics, oncologic data, perioperative characteristics, and complications were examined and reported as means with standard deviations. Cost-saving with the meshed technique was evaluated. Forty-eight patients (72 breasts) with a mean age of 48.5 ± 15.0 years (range 26–70 years) were included in the study. The mean follow-up time was 13.2 ± 4.4 months (range 4.1–25.8 months). Nineteen breasts (24.6%) experienced complications, with seromas being the most common complication (12.5%, n = 9). Expander removal and reoperation occurred at a rate of 8.3 and 9.7%, respectively. The average time to drain removal was 18.8 ± 6.6 days (range 8–32 days). Meshed ADM provided an average cost savings of $6,601 for unilateral and $13,202 for bilateral reconstructions. Our study found that human-derived meshed ADM can be safely used in two-staged prepectoral tissue expander-based breast reconstruction and can result in significant cost savings.

Keywords

acellular dermal matrix - prepectoral - breast reconstruction - meshed - case reports

Author Contributions

Conceptualization: R.N.W.-Jr, N.M., A.C.K., J.P.A. Data curation: J.L., R.N.W.-Jr, S.M.O., M.P. Investigation: J.L., R.N.W.-Jr, A.C.K., J.P.A. Methodology: J.L., R.N.W.-Jr, A.C.K., J.P.A. Project administration: J.L., R.N.W.-Jr, A.C.K., J.P.A. Supervision, validation, visualization: A.C.K., J.P.A. Writing - original draft: J.L., R.N.W.-Jr, S.M.O. Writing - review and editing: J.L., A.C.K., J.P.A.


Ethical Approval

This study was exempted by the Institutional Review Board of University of Utah Hospital (IRB00081784) and performed in accordance with the principles of the Declaration of Helsinki. The informed consent was waived because this study design is a retrospective chart review.


Patient Consent

The patients provided written informed consent for the publication and the use of their images.


Prior Presentation

This article was presented at the Mountain West Society of Plastic Surgeons, Squaw Valley, Lake Tahoe, March 7–10, 2019.


* The two authors contributed equally to this work.




Publikationsverlauf

Artikel online veröffentlicht:
06. April 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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