The Use of Acellular Dermal Matrix to Prevent Capsule Formation around Implants in a Primate Model

Abstract

The use of AlloDerm to partially enclose implants effectively prevented formation of a capsule in areas where AlloDerm contacted the implant at 10 weeks. Long-term studies will be required to determine whether this is a durable result that can be reproduced in humans.

Capsular contracture in implant based breast reconstruction—the effect of porcine acellular dermal matrix

“…In contrast, ADM-assisted reconstructions have consistently been associated with CC rates of <5%, albeit a shorter follow-up period of 0.6-2.4-year (9-15) is reported. Mechanistic studies in animal models as well as human histopathologic studies suggest a reduction or delay in capsule formation in the presence of ADM as a possible explanation for the reduced occurrence of CC (5,(16)(17)(18).…”

“…Although originally intended to provide support and coverage of the breast lower pole, growing evidence suggests that ADM use may also mitigate the risk of capsular contracture (CC) (2)(3)(4)(5).…”

Pre-pectoral implant based breast reconstruction

“…The immunologically inert nature of ADMs has been suggested to confer a protective effect against capsule formation, fibrosis, and contraction by minimizing this inflammatory cascade. [19][20][21] To date in our series, capsular contracture has not been problematic. A low incidence of capsular contracture was also reported in the other recent studies of prepectoral implant-based reconstruction with total ADM coverage.…”

Acellular Dermal Matrix for Optimizing Outcomes in Implant-Based Breast Reconstruction: Primary and Revisionary Procedures

“…In ADM-assisted implant-based primary reconstructions, a low rate of capsular contracture (0%-2%) has been observed (S. Becker et al, 2009;Bindingnavele et al, 2007;Breuing & Colwell, 2007;Namnoum, 2009;Salzberg, 2006;Salzberg et al, 2011;Spear et al, 2008;Zienowicz & Karacaoglu, 2007), suggesting that ADMs may help prevent or reduce the risk of capsular contracture; hence, the rationale for using ADMs for the correction and prevention of capsular contracture. Animal and clinical studies suggest that ADMs may prevent capsular contracture by minimizing the inflammatory response, thereby reducing capsule formation around implants (Basu et al, 2010;Komorowska-Timek et al, 2009;Orenstein et al, 2010;Stump et al, 2009;Uzunismail et al, 2008). Published series have reported successful correction of > 90% of grade 3/4 capsular contractures with the use of ADMs with no recurrences during a mean follow-up period of 9-21 months (Breuing & Colwell;Hartzell et al, 2010;Spear et al, 2011).…”