A large-volume academic center retrospective audit of the temporal evolution of immediate breast reconstruction protocols and the effect on breast prosthetic infection

Manahan, Michele A.; McNichols, Colton H.; Bello, Ricardo J.; Giuliano, Katherine; Xie, Sherlly; Guionneau, Nicholas von; Ahn, Jong Chul; Rosson, Gedge D.; Hui-Chou, Helen G.

doi:10.1016/j.bjps.2018.10.009

Cited by 8 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Screening in the citation manager excluded 333 articles based on clear distinction of abstracts, discussions, replies, case reports, and reviews. Further screening of titles and abstracts by two independent reviewers identified 131 articles for full-text review, and 55 articles were included in the final analysis 10–64 (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Do Corporate Payments Influence Research Related to the Use of Acellular Dermal Matrices in Breast Surgery?

Lee

Diep

Brydges

et al. 2023

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Background: No study has assessed the impact of financial conflicts of interests (COIs) on the reporting of breast reconstruction outcomes with acellular dermal matrix (ADM) in peer-reviewed publications. The authors hypothesized that there is (1) an association between financial COIs and likelihood of studies reporting benefits in using ADM, and (2) inconsistent reporting of financial COIs. Methods: The PubMed database was used to identify articles that reported on the use of ADM in breast surgery in four leading plastic surgery journals from January of 2014 to December of 2019. Financial COIs for authors were determined using the open payments database. Results: Fifty-five articles were included. Twenty-four articles (43.6%) supported use of ADM, 12 (21.8%) did not promote ADM use, and 19 (34.5%) were neutral. Fifty-one studies (92.7%

show abstract

Section: Resultsmentioning

confidence: 99%

Do Corporate Payments Influence Research Related to the Use of Acellular Dermal Matrices in Breast Surgery?

Lee

Diep

Brydges

et al. 2023

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

show abstract

“…4 Single center reviews range from 2.3% to 35.7% for infection, 2.4% to 12.9% for dehiscence, and 1.5% to 5.1% for hematoma complications. 2,3,5,8,18,21 Studies have shown that the majority of SSIs are evident within 90 days of surgery. 5 Our mean follow-up was 90 days.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of SSI has been estimated to be as high as 35% in post-mastectomy breast reconstruction. 2,[4][5][6][7][8][9][10] Complications after these procedures can be a source of significant emotional distress for patients as they can lead to suboptimal aesthetic results, failure of reconstruction, possible need for autologous salvage, and/or significant delay of adjuvant breast cancer treatments.…”

Section: Introductionmentioning

confidence: 99%

Closed-Incision and Surrounding Soft Tissue Negative Pressure Dressings in Post-Mastectomy Pre-Pectoral Direct-to-Implant Breast Reconstruction: A Pilot Study

et al. 2021

View full text Add to dashboard Cite

Background: Closed-incision and surrounding soft tissue negative pressure therapy (cistNPT) is theorized to decrease infection, reduce tissue edema, and promote healing of the mastectomy skin flap. We report our early experience with this dressing in pre-pectoral direct-to-implant (pDTI) breast reconstruction. Methods: We retrospectively reviewed all patients who underwent post-mastectomy pDTI breast reconstruction with cistNPT between July 2019 and February 2020. All reconstructions utilized smooth round silicone gel implants and human acellular dermal matrix. Results: Thirty-five female patients underwent 58 mastectomies. Mean age and body mass index were 49.9 years and 28.9 kg/m2, respectively. Eleven (31.4%) patients had neoadjuvant chemotherapy. The mean sternal notch-to-nipple distance was 27.0 cm. The median specimen weight was 483 g, while the median implant volume was 495 cc. The mean implant-to-specimen ratio was 1.4 for nipple-sparing, 1.1 for skin-sparing, and 0.7 for skin-reducing mastectomy. Total drain volume was 483.1 cc from each breast. Post-operative complications included seroma (5.2%), peri-incisional necrosis (8.6%), and superficial skin epidermolysis (13.8%). There were no cases of surgical site infection, dehiscence, or hematoma. Rate of return to the operative room was 3.4%. Mean follow-up was 90 days. Conclusions: In our series of pDTI breast reconstructions with cistNPT, no patients experienced hematoma, dehiscence, or infection complications. Rates of seroma, skin necrosis requiring operative debridement, and total drain volumes were lower than those reported in literature.

show abstract

“…[5][6][7] Although acellular dermal matrix provides substantial cosmetic benefits in breast reconstruction, some studies have shown that acellular dermal matrix use comes with the increased risk of complications such as seromas and infections. [8][9][10][11][12][13][14][15] However, it has also been shown that with proper handling and good technique, those risks can be reduced to as low as a 0 to 6 percent reconstructive failure rate. 16,17 Capsular contracture is a well-recognized complication following prosthetic breast reconstruction with a variable presentation, from a visible implant to one that is firm and painful.…”

mentioning

confidence: 99%

“…5–7 Although acellular dermal matrix provides substantial cosmetic benefits in breast reconstruction, some studies have shown that acellular dermal matrix use comes with the increased risk of complications such as seromas and infections. 8–15 However, it has also been shown that with proper handling and good technique, those risks can be reduced to as low as a 0 to 6 percent reconstructive failure rate. 16,17…”

mentioning

confidence: 99%

Acellular Dermal Matrix–Associated Contracture: A Clinical and Histologic Analysis of Patients Undergoing Prosthetic Breast Reconstruction

Kearney

Yan

Bricker

et al. 2021

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Background: Capsular contracture is a well-recognized complication following prosthetic breast reconstruction. It has been the authors' observation that some patients undergoing breast reconstruction experience contracture specifically of the acellular dermal matrix placed at the time of their tissue expander insertion. The goal of the authors' study was to identify clinical and histologic findings associated with the development of acellular dermal matrix-associated contracture. Methods: The authors performed a retrospective cohort study of all patients undergoing bilateral implant-based breast reconstruction performed by the senior author (M.S.A.). Patients were excluded if they had radiation therapy to the breast. Patients with suspected acellular dermal matrix-associated contracture were identified by clinical photographs and review of operative notes. Histologic analysis was performed on specimens taken from two patients with acellular dermal matrix contracture. Results: The authors included a total of 46 patients (92 breasts), of which 19 breasts had suspected acellular dermal matrix-associated contracture. Acellular dermal matrix contracture was less common in direct-to-implant reconstruction (4.2 percent versus 26.5 percent; p = 0.020) and more common in breasts that had seromas (0 percent versus 15.8 percent; p = 0.001) or complications requiring early expander replacement. Contracted acellular dermal matrix had less vascularity and a lower collagen I-to-collagen III ratio, and was twice as thick as noncontracted acellular dermal matrix. Conclusions: The authors have described a distinct phenomenon of acellular dermal matrix-associated contracture that occurs in a small subset of breasts where acellular dermal matrix is used. This merits further investigation. Future work will be required to better characterize the clinical factors that make acellular dermal matrix-associated contracture more likely to occur.

show abstract

A large-volume academic center retrospective audit of the temporal evolution of immediate breast reconstruction protocols and the effect on breast prosthetic infection

Cited by 8 publications

References 27 publications

Do Corporate Payments Influence Research Related to the Use of Acellular Dermal Matrices in Breast Surgery?

Do Corporate Payments Influence Research Related to the Use of Acellular Dermal Matrices in Breast Surgery?

Closed-Incision and Surrounding Soft Tissue Negative Pressure Dressings in Post-Mastectomy Pre-Pectoral Direct-to-Implant Breast Reconstruction: A Pilot Study

Acellular Dermal Matrix–Associated Contracture: A Clinical and Histologic Analysis of Patients Undergoing Prosthetic Breast Reconstruction

Contact Info

Product

Resources

About