Use of acellular dermal matrices in laryngotracheal and pharyngeal reconstruction: systematic review

Hui, Aaron; Hong, Paul; Bezuhly, Michael

doi:10.1017/s0022215117001049

Cited by 12 publications

(9 citation statements)

References 31 publications

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“…However, ADMs are regularly used in many types of surgery, without any convincing evidence that they cause an adverse tissue response28, 29. Furthermore, using an ADM in a two‐stage reconstruction is not associated with an increased complication rate, implying that the high complication rate observed here is primarily associated with the surgical technique (direct placement of the definitive implant) and not the ADM30, 31.…”

Section: Discussionmentioning

confidence: 82%

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Negenborn

Dikmans

Bouman

et al. 2018

British Journal of Surgery

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BackgroundIn the multicentre randomized trial BRIOS (Breast Reconstruction In One Stage), direct‐to‐implant (DTI) breast reconstruction with an acellular dermal matrix (ADM) was associated with a markedly higher postoperative complication rate compared with two‐stage tissue expander/implant breast reconstruction. This study aimed to identify factors that contribute to the occurrence of complications after DTI ADM‐assisted breast reconstruction.MethodsData were obtained from the BRIOS study, including all patients treated with DTI ADM‐assisted breast reconstruction. Logistic regression analyses were performed to identify factors predictive of postoperative complications.ResultsFifty‐nine patients (91 breasts) were included, of whom 27 (35 breasts) developed a surgical complication. Reoperations were performed in 29 breasts (32 per cent), with prosthesis removal in 22 (24 per cent). In multivariable analyses, mastectomy weight was associated with complications (odds ratio (OR) 1·94, 95 per cent c.i. 1·33 to 2·83), reoperations (OR 1·70, 1·12 to 2·59) and removal of the implant (OR 1·55, 1·11 to 2·17). Younger patients (OR 1·07, 1·01 to 1·13) and those who received adjuvant chemotherapy (OR 4·83, 1·15 to 20·24) more frequently required reoperation. In univariable analyses, adjuvant radiotherapy showed a trend towards more complications (OR 7·23, 0·75 to 69·95) and removal of the implant (OR 5·12, 0·76 to 34·44), without reaching statistical significance.ConclusionBreast size appeared to be the most significant predictor of complications in DTI ADM‐assisted breast reconstruction. The technique should preferably be performed in patients with small to moderate sized breasts. Registration number: NTR5446 ( http://www.trialregister.nl).

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Section: Discussionmentioning

confidence: 82%

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Negenborn

Dikmans

Bouman

et al. 2018

British Journal of Surgery

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“… 165 – 169 ADM grafts carry lower risk of fistula and stricture formation and avoid donor site complications associated with flap harvest. 165 Thin ADMs are more often used for partial superficial defects in the trachea, larynx or hypopharynx. Thicker sheet ADMs were typically used for complex pharyngeal fistula closure and partial pharyngoplasty for stage III–IV carcinomas.…”

Section: Resultsmentioning

confidence: 99%

“…Thicker sheet ADMs were typically used for complex pharyngeal fistula closure and partial pharyngoplasty for stage III–IV carcinomas. 165 Other successful uses of ADM in otorhinolaryngology include closure of hard palatal fistula and tympanoplasty. 170 , 171 …”

Section: Resultsmentioning

confidence: 99%

Clinical applications of acellular dermal matrices: A review

Petrie

Cox

Becker

2022

Scars, Burns & Healing

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Introduction The extracellular matrix (ECM) plays an integral role in wound healing. It provides both structure and growth factors that allow for the organised cell proliferation. Large or complex tissue defects may compromise host ECM, creating an environment that is unfavourable for the recovery of anatomical function and appearance. Acellular dermal matrices (ADMs) have been developed from a variety of sources, including human (HADM), porcine (PADM) and bovine (BADM), with multiple different processing protocols. The objective of this report is to provide an overview of current literature assessing the clinical utility of ADMs across a broad spectrum of applications. Methods PubMed, MEDLINE, EMBASE, Scopus, Cochrane and Web of Science were searched using keywords ‘acellular dermal matrix’, ‘acellular dermal matrices’ and brand names for commercially available ADMs. Our search was limited to English language articles published from 1999 to 2020 and focused on clinical data. Results A total of 2443 records underwent screening. After removing non-clinical studies and correspondence, 222 were assessed for eligibility. Of these, 170 were included in our synthesis of the literature. While the earliest ADMs were used in severe burn injuries, usage has expanded to a number of surgical subspecialties and procedures, including orthopaedic surgery (e.g. tendon and ligament reconstructions), otolaryngology, oral surgery (e.g. treating gingival recession), abdominal wall surgery (e.g. hernia repair), plastic surgery (e.g. breast reconstruction and penile augmentation), and chronic wounds (e.g. diabetic ulcers). Conclusion Our understanding of ADM’s clinical utility continues to evolve. More research is needed to determine which ADM has the best outcomes for each clinical scenario. Lay Summary Large or complex wounds present unique reconstructive and healing challenges. In normal healing, the extracellular matrix (ECM) provides both structural and growth factors that allow tissue to regenerate in an organised fashion to close the wound. In difficult or large soft-tissue defects, however, the ECM is often compromised. Acellular dermal matrix (ADM) products have been developed to mimic the benefits of host ECM, allowing for improved outcomes in a variety of clinical scenarios. This review summarises the current clinical evidence regarding commercially available ADMs in a wide variety of clinical contexts.

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“…However, these materials were lack of the structural, chemical, biological and mechanical complexity of native extracellular matrix (ECM) 17 . The simple native biomaterials such as allogeneic acellular dermal matrix patches are only used to repair a small range of defects 18–20 . In our experiment, the complex full‐thickness ECM with vascular pedicle scaffold was prepared to solve the large scale of hypopharyngeal defects and has not been reported so far.…”

Section: Introductionmentioning

confidence: 99%

Development of a decellularized hypopharynx with vascular pedicle scaffold for use in reconstructing hypopharynx

Hou

et al. 2022

Artificial Organs

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Background:Hypopharynx reconstruction after hypopharyngectomy is still a great challenge. Perfusion decellularization is for extracellular matrix (ECM) scaffolding and had been used in organ reconstruction. Our study aimed to prepare an acellular, natural, three-dimensional (3D) biological hypopharynx with vascular pedicle scaffold as the substitute materials to reconstruct hypopharynx.Result:Scanning electron microscope (SEM) and immuno showed that the decellularized hypopharynx with vascular pedicle scaffold retained intact native anatomical ECM structure. Myoblasts were observed on the recellularized scaffolds with bone marrow mesenchyml stem cells (BMSCs) induced by 5-azacytidine implanted in the rabbit greater omentum by immunohistochemical analysis. Conclusion:the decellularized hypopharynx with vascular pedicle scaffold prepared by detergent perfusion in our study has an potential to be an alternative material to pharynx reconstruction.

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Use of acellular dermal matrices in laryngotracheal and pharyngeal reconstruction: systematic review

Abstract: Evidence in support of acellular dermal matrix use in head and neck reconstruction is generally poor. Prospective comparative studies are required to define the indications, safety and effectiveness of acellular dermal matrices in laryngotracheal and pharyngeal reconstruction.

Cited by 12 publications

References 31 publications

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Clinical applications of acellular dermal matrices: A review

Development of a decellularized hypopharynx with vascular pedicle scaffold for use in reconstructing hypopharynx

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