Human Acellular Dermis versus No Acellular Dermis in Tissue Expansion Breast Reconstruction

Parks, Joshua W.; Hammond, Sarah; Walsh, Wendy A.; Adams, Robert L.; Chandler, Robert G.; Luce, Edward A.

doi:10.1097/prs.0b013e318262f06e

Cited by 87 publications

(72 citation statements)

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“…No significant differences in seroma formation were found among the ADM groups (P = 0.741) ( Table 3). In addition to axillary dissection, which was found to be a significant variable (P = 0.001) in the univariate analysis, the existing literature suggests that factors such as age, BMI, DM, the amount of ADM, and implant size are closely related to seroma formation [1,[8][9][10][11]. Our results remained significant after adjusting for these factors.…”

Section: Amount Of Drained Serum and Drain Maintenance Periodsupporting

confidence: 55%

“…Chun et al [1] reported that the use of ADM increased the risk of seroma occurrence by 4.24 times, and of infection by 5.37 times, whereas Parks et al [11] reported that it increased the risk of seroma by almost 2 times. Furthermore, Jordan et al [7] reported that such an increase in the occurrence of seroma multiplied the chance of tissue expander removal by 4.42 times and of infection-induced tissue expander removal by 6.71 times [12].…”

Section: Discussionmentioning

confidence: 99%

“…If a drain is hastily removed before drainage decreases adequately, seroma can occur [7,11,15,16]. Few studies have reported the exact removal time of the drain postoperatively.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Amount of Drainage in 3 Acellular Dermal Matrices in Implant-Based Breast Reconstruction: A Retrospective Study

Kim

2017

Arch Aesthetic Plast Surg

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Background Acellular dermal matrix (ADM)-assisted breast reconstruction has gained popularity because it has several advantages. Some studies have reported that the use of ADM was strongly associated with postoperative complications, especially seroma formation. We performed direct-to-implant breast reconstruction using 3 types of human allograft products (CGDerm . The purpose of this study was to obtain information useful for the selection of an ADM product by comparing the amount of collected serum and the maintenance period of the drain. Methods Seventy-three patients with breast cancer who underwent ADM-assisted implant breast reconstruction between March 2011 and January 2016 were included in this study. The patients were divided into 3 groups based on the type of ADM that was used. The demographic characteristics collected were: age, body mass index (BMI), breast reconstruction location, smoking history, axillary dissection, comorbidities (such as hypertension and diabetes mellitus [DM]), breast implant size, breast implant type, amount of ADM, the total amount of serum that was collected in the drain, and the maintenance period of the drain. Results We obtained significant results after adjusting for variables including age, BMI, DM, axillary dissection, ADM amount, and breast implant size. Compared to AlloDerm, MegaDerm showed a significantly smaller amount of total drained serum and a significantly shorter drain maintenance period. Conclusions The use of MegaDerm led to smaller amounts of drained serum and a shorter drain maintenance period than when AlloDerm was used. In contrast, no significant differences were found between CGDerm and AlloDerm, or between CGDerm and MegaDerm.

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Section: Amount Of Drained Serum and Drain Maintenance Periodsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Comparison of the Amount of Drainage in 3 Acellular Dermal Matrices in Implant-Based Breast Reconstruction: A Retrospective Study

Kim

2017

Arch Aesthetic Plast Surg

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“…However, several studies have also shown increased rates of seroma formation in patients who have undergone AlloDerm-associated (LifeCell Corp., Branchburg, NJ) reconstructions [16,17,22,23], with an incidence ranging from 0 to 9 % in one particular systematic review [1]. Poor contact between the ADM and overlying tissues secondary to irregularity at the soft tissue interface and intentional under inflation of the tissue expander have been cited as reasons for these increased seroma rates [8,22].…”

Section: Discussionmentioning

confidence: 99%

Acellular dermal matrix fenestrations and their effect on breast shape

et al. 2015

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Background Acellular dermal matrices (ADMs) are increasingly being utilized in primary and secondary breast reconstruction as they confer several advantages, including soft tissue enhancement at the inferolateral pole of the breast. The senior authors have added fenestrations to ADMs to allow for more rapid expansion and improved breast aesthetics. The purpose of this study is to describe the benefits of ADM fenestration using a mathematical formula as a proof of concept for the effects of these modifications on breast shape. Methods The aggregate effect of symmetrically arranged fenestrations on the ADM's mechanical properties is explained by a uniform reduction in the effective Young's modulus of the graft in a direction perpendicular to the chest wall in the area of graft fenestration. Asymmetric reduction of the Young's modulus is achieved by concentration of the fenestrations at either the cephalic or caudal ends of the ADM. Results The relaxed Young's modulus facilitates an increased deflection of the ADM from its resting, unaltered state under the weight of the implant or tissue expander and is modeled using a one-dimensional boundary equation. The reduced inferior pole tension allows for enhanced expansion under the weight of the implant or tissue expander. The effects of asymmetrically arranged fenestrations are similarly modeled and appear to afford the surgeon greater precision in controlling inferior pole characteristics.Conclusions Acellular dermal matrix fenestration improves aesthetic outcome by facilitating greater inferior pole expansion. Mathematical models are provided to describe the modifications and elucidate the mechanism behind their effect on breast shape. Level of Evidence: Not ratable

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“…In the original report of Breuing as well as in five subsequent randomized studies the effectiveness and success of immediate reconstruction when using ADM were proven [38,41,42,[47][48][49]. In these retrospective studies, the overall incidence of complications was between 6,9% and 25%.…”

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confidence: 95%

Biological and Synthetic Mesh Use in Reconstructive Surgery in Patients With Breast Cancer

Ермощенкова¹,

Чиссов²,

Usov³

et al. 2017

Issled. prakt. med. (Print)

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Introduction. In recent years, considerable success has been achieved in complex and combined treatment of breast cancer (BC). Reconstructive plastic surgery plays an important role in the rehabilitation of patients with breast cancer and it is currently considered as the causal treatment of mental disorders caused by loss of femininity and integrity of one's own body. One-step breast reconstruction for cancer treatment makes it possible to use supplementary materials -synthetic and biological implants that can replace muscle autografts and thereby reduce trauma, blood loss, operation time, and thereby help to avoid the defect of donor areas. The authors describe the state of the art at present and demonstrate the results of their own research.

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Human Acellular Dermis versus No Acellular Dermis in Tissue Expansion Breast Reconstruction

Abstract: The presence of acellular dermis did not increase the incidence of tissue expander loss, despite a doubling of frequency of seroma. Prior radiation and use of acellular dermis did culminate in a prohibitively high loss rate of the tissue expander.

Cited by 87 publications

References 0 publications

Comparison of the Amount of Drainage in 3 Acellular Dermal Matrices in Implant-Based Breast Reconstruction: A Retrospective Study

Comparison of the Amount of Drainage in 3 Acellular Dermal Matrices in Implant-Based Breast Reconstruction: A Retrospective Study

Acellular dermal matrix fenestrations and their effect on breast shape

Biological and Synthetic Mesh Use in Reconstructive Surgery in Patients With Breast Cancer

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