Sterile “Ready-to-Use” AlloDerm Decreases Postoperative Infectious Complications in Patients Undergoing Immediate Implant-Based Breast Reconstruction with Acellular Dermal Matrix

Weichman, Katie E.; Wilson, Stelios C.; Saadeh, Pierre B.; Hazen, Alexes; Levine, Jamie P.; Choi, Mihye; Karp, Nolan S.

doi:10.1097/prs.0b013e31829fe35b

Cited by 92 publications

(84 citation statements)

References 29 publications

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“…): key word searches included AlloDerm + cryopreserved + free-dried + sterile + ready-to-use], this is the second comparative study evaluating the complication rates between cryopreserved AlloDerm and its new ready-to-use version. 1 AlloDerm was first used in breast surgery in 2001 and its use in breast reconstruction was first published in 2005. 2–4 The original version of AlloDerm, cryopreserved AlloDerm, has been widely published.…”

Section: Discussionmentioning

confidence: 99%

Comparison between Freeze-dried and Ready-to-use AlloDerm in Alloplastic Breast Reconstruction

Yuen

Yue

Erickson

et al. 2014

Plastic and Reconstructive Surgery Global Open

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Background:AlloDerm, a brand of acellular dermal matrix, is commonly used as an internal hammock to support the tissue expander or permanent implant in breast reconstruction. The aim of our study is to evaluate the complication rates associated with the freeze-dried (FD) AlloDerm and the ready-to-use (RTU) AlloDerm.Methods:This institutional review board–approved retrospective study involved 103 patients who underwent immediate postmastectomy breast reconstructions from June 2011 to August 2012. The first 51 patients underwent 96 immediate breast reconstructions with FD AlloDerm. The subsequent 52 patients underwent 100 immediate breast reconstructions with RTU AlloDerm. Patient demographics, postoperative complication rates in study cohort, and complication rates stratified by body mass index (BMI) were analyzed.Results:Multiple patient demographics in the 2 cohorts are closely matched (P > 0.05). RTU AlloDerm was associated with higher rates of seroma and cellulitis compared with FD AlloDerm (22.0% vs 18.8%, P = 0.599 and 21.0% vs 12.5%, P = 0.129, respectively). Significantly higher rates of seroma and cellulitis were found in patients with BMI ≥ 30 compared with BMI < 30 (34.5% vs 9.2%, P < 0.001 and 29.9% vs 6.4%, P < 0.001, respectively). A generalized linear mixed model shows that obesity and RTU AlloDerm are statistically significant predictors of cellulitis (adjusted odds ratio = 10.413, P < 0.001 and adjusted odds ratio = 3.712, P = 0.011, respectively).Conclusions:Our study demonstrates a clinically higher postoperative complication rate in immediate breast reconstruction with RTU AlloDerm compared with FD AlloDerm and highlights the unfavorable risk factor correlation with significant obesity.

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Section: Discussionmentioning

confidence: 99%

Comparison between Freeze-dried and Ready-to-use AlloDerm in Alloplastic Breast Reconstruction

Yuen

Yue

Erickson

et al. 2014

Plastic and Reconstructive Surgery Global Open

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“…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%

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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“…Animal models have shown no long-term differences in the physical properties of both types of ADM. 7 A recent study has demonstrated an overall parity of complication rates between RTU and total submuscular coverage of implants. 4 A prospective trial investigating sterile ADM found lowered infection and seroma rates with equivalent graft incorporation to aseptic ADM. 8 To date, a comprehensive analysis of etiology and risk factors for the development of red breast syndrome (RBS) has not been performed. Despite routinely meticulous sterile tissue, some patients experience idiopathic postoperative erythema, or RBS.…”

Section: Introductionmentioning

confidence: 99%

“…Increased morbidity, namely, infection, seroma, and flap necrosis, has been reported. 4 A meta-analysis showed that the use of ADMs may increase the odds of infection 5.37 times. 5 New products are introduced periodically, asserting improvements in efficiency, cost, and complication occurrence.…”

Section: Introductionmentioning

confidence: 99%

Reducing Postoperative Infections and Red Breast Syndrome in Patients With Acellular Dermal Matrix–Based Breast Reconstruction

Lewis

Jewell

Mattison

et al. 2015

Annals of Plastic Surgery

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According to our study, sterile AlloDerm has a clinically decreased incidence of complications compared to aseptic AlloDerm. Whereas RBS decreased, it was interesting to see that it was not eliminated altogether. This suggests that the etiology may be unrelated to ADM processing and warrants further investigation. Overall, the most notable difference was the statistically significant decrease in the total complication rate. Therefore, the change to sterile AlloDerm seems to be beneficial. Further benefit arises from ease of preparation in the operating room.

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Sterile “Ready-to-Use” AlloDerm Decreases Postoperative Infectious Complications in Patients Undergoing Immediate Implant-Based Breast Reconstruction with Acellular Dermal Matrix

Abstract: Therapeutic, II.

Cited by 92 publications

References 29 publications

Comparison between Freeze-dried and Ready-to-use AlloDerm in Alloplastic Breast Reconstruction

Comparison between Freeze-dried and Ready-to-use AlloDerm in Alloplastic Breast Reconstruction

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

Reducing Postoperative Infections and Red Breast Syndrome in Patients With Acellular Dermal Matrix–Based Breast Reconstruction

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