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DOI: 10.5999/aps.2016.43.6.523
The Effect of Sterile Acellular Dermal Matrix Use on Complication Rates in Implant-Based Immediate Breast Reconstructions
This article was supported by Yeungnam University grants in 2014.
Background The use of acellular dermal matrix (ADM) in implant-based immediate breast reconstruction has been increasing. The current ADMs available for breast reconstruction are offered as aseptic or sterile. No published studies have compared aseptic and sterile ADM in implant-based immediate breast reconstruction. The authors performed a retrospective study to evaluate the outcomes of aseptic versus sterile ADM in implant-based immediate breast reconstruction.
Methods Implant-based immediate breast reconstructions with ADM conducted between April 2013 and January 2016 were included. The patients were divided into 2 groups: the aseptic ADM (AlloDerm) group and the sterile ADM (MegaDerm) group. Archived records were reviewed for demographic data and postoperative complication types and frequencies. The complications included were infection, flap necrosis, capsular contracture, seroma, hematoma, and explantation for any cause.
Results Twenty patients were reconstructed with aseptic ADM, and 68 patients with sterile ADM. Rates of infection (15.0% vs. 10.3%), flap necrosis (5.0% vs. 7.4%), capsular contracture (20.0% vs. 14.7%), seroma (10.0% vs. 14.7%), hematoma (0% vs. 1.5%), and explantation (10.0% vs. 8.8%) were not significantly different in the 2 groups.
Conclusions Sterile ADM did not provide better results regarding infectious complications than aseptic ADM in implant-based immediate breast reconstruction.
This article was presented at Aesthetic Plastic Surgery 2014 on April 26, 2014 in Seoul, Korea.
Publication History
Received: 27 May 2016
Accepted: 28 September 2016
Article published online:
20 April 2022
© 2016. 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-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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References
- 1 Salzberg CA. Direct-to-implant breast reconstruction. Clin Plast Surg 2012; 39: 119-126
- 2 Chun YS, Verma K, Rosen H. et al. Implant-based breast reconstruction using acellular dermal matrix and the risk of postoperative complications. Plast Reconstr Surg 2010; 125: 429-436
- 3 JoAnna Nguyen T, Carey JN, Wong AK. Use of human acellular dermal matrix in implant- based breast reconstruction: evaluating the evidence. J Plast Reconstr Aesthet Surg 2011; 64: 1553-1561
- 4 Spear SL, Pelletiere CV, Lockwood M. Immediate breast reconstruction with tissue expanders and AlloDerm. In: Spear SL, Willey SC, Robb GL. et al. Surgery of the breast: principles and art. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2006: 484-488
- 5 United States Pharmacopeial Convention. 1211: Sterility testing. United States Pharmacopeia and National Formulary (USP25-NF20) Rockville: United States Pharmacopeial Convention; 2002
- 6 Centers for Disease Control and Prevention (CDC). Update: allograft-associated bacterial infections: United States, 2002. MMWR Morb Mortal Wkly Rep. 2002. 51. 207-210
- 7 Losken A. Early results using sterilized acellular human dermis (Neoform) in post-mastectomy tissue expander breast reconstruction. Plast Reconstr Surg 2009; 123: 1654-1658
- 8 Buseman J, Wong L, Kemper P. et al. Comparison of sterile versus nonsterile acellular dermal matrices for breast reconstruction. Ann Plast Surg 2013; 70: 497-499
- 9 Weichman KE, Wilson SC, Saadeh PB. et al. Sterile “ready-to-use” AlloDerm decreases postoperative infectious complications in patients undergoing immediate implant-based breast reconstruction with acellular dermal matrix. Plast Reconstr Surg 2013; 132: 725-736
- 10 Venturi ML, Mesbahi AN, Boehmler 4th JH. et al. Evaluating sterile human acellular dermal matrix in immediate expander-based breast reconstruction: a multicenter, prospective, cohort study. Plast Reconstr Surg 2013; 131: 9e-18e
- 11 Breuing KH, Warren SM. Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings. Ann Plast Surg 2005; 55: 232-239
- 12 Liu AS, Kao HK, Reish RG. et al. Postoperative complications in prosthesis-based breast reconstruction using acellular dermal matrix. Plast Reconstr Surg 2011; 127: 1755-1762
- 13 Antony AK, McCarthy CM, Cordeiro PG. et al. Acellular human dermis implantation in 153 immediate two-stage tissue expander breast reconstructions: determining the incidence and significant predictors of complications. Plast Reconstr Surg 2010; 125: 1606-1614
- 14 Lanier ST, Wang ED, Chen JJ. et al. The effect of acellular dermal matrix use on complication rates in tissue expander/implant breast reconstruction. Ann Plast Surg 2010; 64: 674-678
- 15 Nahabedian MY. AlloDerm performance in the setting of prosthetic breast surgery, infection, and irradiation. Plast Reconstr Surg 2009; 124: 1743-1753
- 16 Vardanian AJ, Clayton JL, Roostaeian J. et al. Comparison of implant-based immediate breast reconstruction with and without acellular dermal matrix. Plast Reconstr Surg 2011; 128: 403e-410e
- 17 Yuen JC, Yue CJ, Erickson SW. et al. Comparison between freeze-dried and ready-to-use AlloDerm in alloplastic breast reconstruction. Plast Reconstr Surg Glob Open 2014; 2: e119
- 18 Lee JH, Kim HG, Lee WJ. Characterization and tissue incorporation of cross-linked human acellular dermal matrix. Biomaterials 2015; 44: 195-205