Clinical experience with Surgimend in breast reconstruction: an overview

Bassetto, Franco; Pandis, Laura

doi:10.12968/hmed.2018.0428c

Cited by 4 publications

(7 citation statements)

References 34 publications

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“…Capsular contraction was rare, and most breasts were categorized as Baker grade I/II. Histological analysis of bovine ADM shows a low level of inflammatory reaction, 35 suggesting that ADM causes a reduction in the incidence of capsular contracture in IBR, 13 , 18 , 34 , 36 a finding that aligns with our findings. A meta-analysis of 912 breasts reported zero capsular contracture rate in bovine ADM-supported IBR.…”

Section: Discussionsupporting

confidence: 90%

“…Complication rates regarding hematoma, seroma, and skin flap and nipple necroses identified in our study align with findings from other studies. 17 , 18 , 31 Some studies, although not prospective, investigated human and porcine-derived ADM up to 8 and 9 years postoperatively and reported relatively stable results with low overall long-term complication rates. 13 , 32 Our findings are in line with these studies and suggest that most complications occur within the initial months following surgery.…”

Section: Discussionmentioning

confidence: 99%

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A Long-term Evaluation of Acellular Dermal Matrix for Immediate Implant-based Breast Reconstruction following Risk-reducing Mastectomy

Khan,

Wickman,

Schultz

2024

Plastic and Reconstructive Surgery - Global Open

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Background: Acellular dermal matrices (ADMs) are sometimes used in implant-based breast reconstructions (IBR), but long-term ADM-related evaluations are scarce. In this study, we evaluated early and late complications and patient-related outcomes (PROs) over an 8-year postoperative period in women who had undergone immediate IBR following risk-reducing mastectomy with bovine ADM (SurgiMend). Methods: This prospective observational single-center analysis involved 34 women at high risk for breast carcinoma. Complications were prospectively recorded during the first year, followed by 4 years of postoperative retrospective chart reviews. Long-term evaluations were done using a questionnaire. Preoperative, 1 year, and 5- to 8-year postoperative PRO assessments were obtained based on results from the BREAST-Q questionnaire. Results: In 56 breasts, complications after a mean of 12.4 months follow-up included implant loss (7.1%), implant change (1.8%), hematoma (7.1%), breast redness (41.1%), and seroma (8.9%). Most breasts (80.3%) were graded Baker I/II, which indicated a low capsular contracture incidence. After a mean of 6.9 years, the total implant explantation rate was 33.9%, and the revision surgery rate was 21.4%. Two cases of breast cancer were reported during the long-term evaluation. BREAST-Q results indicated significantly decreased satisfaction with outcome (P = 0.024). A positive trend regarding psychosocial well-being and declining trend regarding satisfaction with both breast physical- and sexual well-being parameters were reported. Conclusions: The observed complication rates agree with previous findings concerning ADM-assisted IBR. A high demand for revision surgery exists, and PROs remain relatively stable over time.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

A Long-term Evaluation of Acellular Dermal Matrix for Immediate Implant-based Breast Reconstruction following Risk-reducing Mastectomy

Khan,

Wickman,

Schultz

2024

Plastic and Reconstructive Surgery - Global Open

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“…As for the enhanced post-operative results in the ADM group, they could be explained by the improved quality of soft tissue covering prosthesis anteriorly and with the application of a dermal matrix over the posterior capsule, left in place after anterior capsulectomy. In addition, an efficacious unloading of the weight of the prostheses over the suture of the matrix could explain the improved chest well-being score in the ADM group [ 28 , 40 ]. On the contrary, the significant improvement of sexual well-being after surgery in the control group could be related to the differences in preoperative sexual well-being, which was lower in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…The use of ADMs for the treatment of capsular contracture is gaining popularity, with many papers describing the use of human-derived ADM with complete or partial implant coverage [ 28 ]. Cheng et al in 2013 reported a novel technique with improved results in reducing capsular contracture [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Complete Implant Wrapping with Porcine-Derived Acellular Dermal Matrix for the Treatment of Capsular Contracture in Breast Reconstruction: A Case–Control Study

et al. 2022

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Background Capsular contracture (CC) represents one of the most common complications in breast reconstruction surgery, impairing final result and patients’ well-being. The role of acellular dermal matrixes (ADM) has been widely described for the treatment and prevention of contracture. The aim of the study was to evaluate the efficacy and safety of complete implant coverage with porcine-derived ADM in preventing CC limiting complications. In addition, patients’ reported outcomes were evaluated in order to define the role of ADM in improving sexual, physical and psychosocial well-being and satisfaction. Methods 42 patients who underwent surgical treatment of 46 contracted reconstructed breasts from May 2018th to May 2019th were collected in the two groups (ADM group vs. Control group). Results The ADM group showed lower rate of CC recurrence and a higher rate of implant losses and minor complications. A significant difference was observed in red breast syndrome (27.3% in the ADM group vs. absent in control the group) and skin ulceration rates (18.2% in the ADM group vs. 4.18% in the control group). As for patients’ perceived outcomes, the ADM group showed a statistically significant higher postoperative Satisfaction of Breast Scale score compared to the control group. In addition, a significant difference was observed in the improvement of Physical Well-Being of the Chest Scale and the Satisfaction of Breast Scale after surgery, in favor to the ADM group. Conclusion Complete implant coverage with ADM may reduce the risk of CC recurrence in breast reconstruction. An accurate patient selection allows minimizing complications improving patient well-being and satisfaction. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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“…As a consequence, various ADMs were used, depending on the availability in every single center. Nevertheless, all the devices were considered equal in efficacy and safety terms, as it has been proved in several studies [52][53][54].…”

Section: Discussionmentioning

confidence: 99%

Dual-Plane Retro-pectoral Versus Pre-pectoral DTI Breast Reconstruction: An Italian Multicenter Experience

2020

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Background The use of conservative mastectomies has risen significantly during the last few years. The reconstructive choice of direct-to-implant reconstruction has become more practicable with modern mastectomy techniques. The initial trend in Italian centers was to use dualplane hybrid reconstruction. However, a high level of complications has been registered. From 2015 onward, in our centers, a pre-pectoral approach has been adopted. The authors sought to describe the Italian trend to gradually discard the sub-pectoral technique with lower lateral pole coverage of the prosthesis using ADMs comparing it with the pre-pectoral approach with ADMs, without any muscle dissection, in terms of complication rates. Materials and Methods A multicenter retrospective clinical study was performed from January 2010 to June 2018. The enrolled patients were divided into two groups: Cases with an ADM-only coverage pre-pectoral reconstruction made up the first group (Group 1). Those with the retropectoral muscular position ? ADM implant coverage comprised the second one (Group 2). Complications such as seroma, hematoma, wound dehiscence, surgical site infection, reconstruction failure, animation deformity and capsular contracture were recorded. Results We performed 716 direct-to-implant reconstructions: 509 were partially sub-pectoral and 207 were prepectoral. Minimum follow-up was 1 year. Incidence of complications was higher in dual-plane reconstructions. There were statistical significant differences in the rates of seroma and hematoma. Conclusion Using the pre-pectoral approach, the authors have experienced favorable aesthetics and superior clinical and functional outcomes. Retro-pectoral muscular ADM implant coverage has to be considered only in specific complicated second-stage surgeries.

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Clinical experience with Surgimend in breast reconstruction: an overview

Cited by 4 publications

References 34 publications

A Long-term Evaluation of Acellular Dermal Matrix for Immediate Implant-based Breast Reconstruction following Risk-reducing Mastectomy

A Long-term Evaluation of Acellular Dermal Matrix for Immediate Implant-based Breast Reconstruction following Risk-reducing Mastectomy

Complete Implant Wrapping with Porcine-Derived Acellular Dermal Matrix for the Treatment of Capsular Contracture in Breast Reconstruction: A Case–Control Study

Dual-Plane Retro-pectoral Versus Pre-pectoral DTI Breast Reconstruction: An Italian Multicenter Experience

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