Drain secretion and seroma formation after immediate breast reconstruction with a biological and a synthetic mesh, respectively: A randomized controlled study

Hansson, Emma; Edvinsson, Ann-Chatrin; Hallberg, Håkan

doi:10.1111/tbj.13921

Cited by 8 publications

(15 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of 603 searched studies through the PubMed, MEDLINE, and Embase databases, following their review by two independent reviewers, 61 studies were included for the full-text reading, of which 17 studies were finally included for the network meta-analysis [2,3,5,9,[12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Resultsmentioning

confidence: 99%

Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

Background:In breast reconstruction, synthetic meshes are frequently used to replace acellular dermal matrix (ADM), since ADM is expensive and often leads to complications.However, there is limited evidence that compares the types of substitutes. This study aimed to compare complications between materials via a network meta-analysis. Methods:We systematically reviewed studies reporting any type of complication from 2010 to 2021. The primary outcomes were the proportion of infection, seroma, major complications, or contracture. We classified the intervention into four categories: ADM, absorbable mesh, non-absorbable mesh, and nothing used. We then performed a network meta-analysis between these categories and estimated the odds ratio with random-effect models. Results:Of 603 searched studies through the PubMed, MEDLINE, and Embase databases, following their review by two independent reviewers, 61 studies were included for full-text reading, of which 17 studies were finally included. There was a low risk of bias in the included studies, but only an indirect comparison between absorbable and non-absorbable mesh was possible. Infection was more frequent in ADM but not in the two synthetic mesh groups, namely the absorbable or non-absorbable types, compared with the non-mesh group. The proportion of seroma in the synthetic mesh group was lower (odds ratio was 0.2 for the absorbable and 0.1 for the non-absorbable mesh group) than in the ADM group. Proportions of major complications and contractures did not significantly differ between groups. Conclusion:Compared with ADM, synthetic meshes have low infection and seroma rates. However, more studies concerning aesthetic outcomes and direct comparisons are needed.

show abstract

Section: Resultsmentioning

confidence: 99%

Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Alloderm-RTU and DermACELL are considered to be amongst the more popular but also more expensive ADM products in the breast reconstruction market. Alternative synthetic meshes such as those used for hernia repairs are also being used in breast reconstruction and are relatively less expensive [ 22 , 43 ]. The purpose of the study was to evaluate the two most commonly used ADM’s.…”

Section: Discussionmentioning

confidence: 99%

“…The primary outcome of the study was drain duration. The literature reports the mean drain duration for subpectoral immediate prosthetic based reconstruction with ADM to be in the range of 8–12 days [ 19 , 21 , 22 , 23 ]. As such, the plastic and breast surgeons in this study determined that a minimum of 4 days in drain duration between the two arms was considered clinically significant.…”

Section: Methodsmentioning

confidence: 99%

A Randomized Controlled Trial Comparing Alloderm-RTU with DermACELL in Immediate Subpectoral Implant-Based Breast Reconstruction

et al. 2020

View full text Add to dashboard Cite

Background: The effectiveness of different acellular dermal matrices (ADM) used for implant-based reconstruction immediately following mastectomy is an important clinical question. A prospective randomized clinical trial was performed to evaluate the superiority of DermACELL over Alloderm-RTU in reducing drain duration. Methods: Patients undergoing mastectomy with subpectoral immediate and permanent implant-based breast reconstruction were randomized to Alloderm-RTU or DermACELL. The primary outcome was seroma formation, measured by the duration of postoperative drain placement. Secondary outcomes included: post drain removal seroma aspiration, infection, redbreast syndrome, wound dehiscence, loss of the implant, and unplanned return to the operating room. Results: 62 patients were randomized for 81 mastectomies (41 Alloderm-RTU, 40 DermACELL). Baseline characteristics were similar. There was no statistically significant difference in mean drain duration (p = 0.16), with a trend towards longer duration in the Alloderm-RTU group (1.6 days; 95%CI, 0.7 to 3.9). The overall rate of minor and major complications were statistically similar between the two groups; although patients with Alloderm-RTU had 3 times as many infections requiring antibiotics (7.9% vs. 2.5%) with a risk difference of 5.4 (95%CI −4.5 to 15.2), and twice as many unplanned returns to the operating room (15.8% vs. 7.5%) with a risk difference of 8.3 (95% CI −5.9 to 22.5) as DermACELL. Conclusion: This is the first prospective randomized clinical trial comparing the two most commonly used human-derived ADMs. There was no statistically significant difference in drain duration, minor, or major complications between DermACELL over Alloderm-RTU in immediate subpectoral permanent implant-based breast reconstruction post-mastectomy.

show abstract

“…The study is reported according to the CONSORT guidelines 17 . Previously, complications 6 , drain secretion 18 , and histological findings 19 have been reported for the participants. The study was vetted and approved by the Regional Ethical Committee of Gothenburg (189-16) and conducted in accordance with the Helsinki Declaration and the Good Clinical Practice (GCP) guidelines.…”

Section: Study Design Protocol and Ethicsmentioning

confidence: 98%

Are patients most satisfied with a synthetic or a biological mesh in dual-plane immediate breast reconstruction after 5 years? A randomized controlled trial comparing the two meshes in the same patient

Paganini¹,

Meyer²,

Hallberg³

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

Self Cite

View full text Add to dashboard Cite

Drain secretion and seroma formation after immediate breast reconstruction with a biological and a synthetic mesh, respectively: A randomized controlled study

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 8 publications

References 17 publications

Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network Meta-Analysis

Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network Meta-Analysis

A Randomized Controlled Trial Comparing Alloderm-RTU with DermACELL in Immediate Subpectoral Implant-Based Breast Reconstruction

Are patients most satisfied with a synthetic or a biological mesh in dual-plane immediate breast reconstruction after 5 years? A randomized controlled trial comparing the two meshes in the same patient

Contact Info

Product

Resources

About