Cost minimisation analysis of using acellular dermal matrix (Strattice™) for breast reconstruction compared with standard techniques

Johnson, Richard K.; Wright, Chloe; Gandhi, Ashu; Charny, Mark; Barr, Lester

doi:10.1016/j.ejso.2012.12.002

Cited by 43 publications

(19 citation statements)

References 6 publications

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“…The primary papers evaluated 12 973 ADM‐assisted IBBRs in 10 260 women, and included one RCT (36 reconstructions in 36 women), 40 comparative studies (11 224 reconstructions in 9152 women) and 20 case series (1713 reconstructions in 1072 women) ( Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 28 studies comparing IBBR with and without ADM, 12 suggested the complication rate to be higher in the ADM group; 12 suggested equivalence between ADM‐assisted and standard procedures, and two suggested that the complication rate may be lower when ADM was used. The remaining two studies did not comment on comparative complication rates. Nine studies compared different types of ADM.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐three studies (1 RCT, 21 comparative studies and 11 case series) reported a total of 26 different process‐related outcomes. The most common were initial intraoperative expander fill volume (21), expander parameters such as size of prosthesis inserted (12), time to second stage (16) and number of expansions (14), but there was a lack of consistency in outcome selection between studies.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review and critical appraisal of the impact of acellular dermal matrix use on the outcomes of implant-based breast reconstruction

Potter

Browning

Savović

et al. 2015

British Journal of Surgery

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review and critical appraisal of the impact of acellular dermal matrix use on the outcomes of implant-based breast reconstruction

Potter

Browning

Savović

et al. 2015

British Journal of Surgery

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“…The data retrieved from the analysis of the literature did not permit to stratify the observations in relation to the RXT; it is specified by some authors that the risk factors were evenly distributed among groups. Another source of perplexity could rise from the consideration that, for its relatively elevated cost [48], the use of ADM could be addressed to patients with a lower risk for complications, or with a more favourable stage of the cancer. This factor, poorly investigated until now [2, 38], could put the suggested protective effect under a more relative point of view.…”

Section: Discussionmentioning

confidence: 99%

Acellular Dermal Matrices and Radiotherapy in Breast Reconstruction: A Systematic Review and Meta-Analysis of the Literature

Valdatta

Cattaneo

Pellegatta³

et al. 2014

Plastic Surgery International

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The increasing use of commercially available acellular dermis matrices for postmastectomy breast reconstruction seems to have simplified the surgical procedure and enhanced the outcome. These materials, generally considered to be highly safe or with only minor contraindications due to the necessary manipulation in preparatory phases, allow an easier one-phase surgical procedure, in comparison with autologous flaps, offering a high patient satisfaction. Unfortunately, the claim for a higher rate of complications associated with irradiation at the implant site, especially when the radiation therapy was given before the reconstructive surgery, suggested a careful behaviour when this technique is preferred. However, this hypothesis was never submitted to a crucial test, and data supporting it are often discordant or incomplete. To provide a comprehensive analysis of the field, we searched and systematically reviewed papers published after year 2005 and registered clinical trials. On the basis of a meta-analysis of data, we conclude that the negative effect of the radiotherapy on the breast reconstruction seems to be evident even in the case of acellular dermis matrices aided surgery. However, more trials are needed to make solid conclusions and clarify the poor comprehension of all the factors negatively influencing outcome.

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“…[8][9][10][11] Grover et al [12] compared five methods of breast reconstruction-autologous flaps with pedicled tissue, autologous flaps with free tissue, LD flaps with breast implants, expanders with implant exchange and immediate implant placement. They concluded "that autologous pedicled tissue was slightly more cost-effective than free tissue reconstruction", and that "implant based techniques were not cost-effective".…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of one-stage versus two-stage breast reconstruction in the United Kingdom

Teo¹,

Azmy²

2015

Plast Aesthet Res

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of a saline implant and permit long-term, noninvasive adjustment of breast size. Reconstruction can, therefore, be completed as a single procedure. The implant is placed at the index procedure, expansion achieved with repeat outpatient injections of saline until optimum breast size is reached. The traditional two-stage reconstruction, however, involves two operations, the first involving the , at a mean of 12.9 months postimplantation, the majority of which were exchanged for silicone implants to improve cosmesis. Four (9%) of the two-stage procedures were explanted a mean of 18 months postreconstruction. Overall, one-stage reconstructions were significantly more expensive than the two-stage group (P = 0.016). Conclusion:There are many benefits of one-stage breast reconstruction. However, it does not appear to be cost-effective when additional admissions for explantation surgery are taken into account. Key words:Breast Received: 03-01-2015; Accepted: 24-09-2015 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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Cost minimisation analysis of using acellular dermal matrix (Strattice™) for breast reconstruction compared with standard techniques

Cited by 43 publications

References 6 publications

Systematic review and critical appraisal of the impact of acellular dermal matrix use on the outcomes of implant-based breast reconstruction

Systematic review and critical appraisal of the impact of acellular dermal matrix use on the outcomes of implant-based breast reconstruction

Acellular Dermal Matrices and Radiotherapy in Breast Reconstruction: A Systematic Review and Meta-Analysis of the Literature

Cost-effectiveness of one-stage versus two-stage breast reconstruction in the United Kingdom

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