First Experience Using Contrast-enhanced Ultrasound to Evaluate Vascularisation of Acellular Dermal Matrices after Implant-Based Breast Reconstruction

Background. While the benefits of using acellular dermal matrices (ADMs) in breast reconstruction are well described, their use has been associated with additional complications. The purpose of this study was to determine if ADM thickness affects complications in breast reconstruction. Methods. A retrospective chart review was performed including all tissue expander based breast reconstructions with AlloDerm (LifeCell, Branchburg, NJ) over 4 years. We evaluated preoperative characteristics and assessed postoperative complications including seroma, hematoma, infection, skin necrosis, and need for reintervention. We reviewed ADM thickness and time to Jackson-Pratt (JP) drain removal. Results. Fifty-five patients underwent 77 ADM-associated tissue expander based breast reconstructions, with average age of 48.1 years and average BMI of 25.9. Average ADM thickness was 1.21 mm. We found higher complication rates in the thick ADM group. Significant associations were found between smokers and skin necrosis (p<0.0001) and seroma and prolonged JP drainage (p=0.0004); radiated reconstructed breasts were more likely to suffer infections (p=0.0085), and elevated BMI is a significant predictor for increased infection rate (p=0.0037). Conclusion. We found a trend toward increased complication rates with thicker ADMs. In the future, larger prospective studies evaluating thickness may provide more information.

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Dermal autografts as a substitute for acellular dermal matrices (ADM) in tissue expander breast reconstruction: A prospective comparative study

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2013.07.002 ◽

2013 ◽

Vol 66 (11) ◽

pp. 1534-1542 ◽

Cited By ~ 17

Author(s):

Michael P. Lynch ◽

Michael T. Chung ◽

Brian D. Rinker

Keyword(s):

Breast Reconstruction ◽

Comparative Study ◽

Tissue Expander ◽

Prospective Comparative Study ◽

Dermal Matrices ◽

Acellular Dermal

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Comparison of irradiated and non-irradiated acellular dermal matrices in breast reconstruction under radiotherapy

Archives of Plastic Surgery ◽

10.5999/aps.2020.01522 ◽

2021 ◽

Vol 48 (1) ◽

pp. 33-43

Author(s):

Soo Jin Woo ◽

Jeong Hyun Ha ◽

Ung Sik Jin

Keyword(s):

Breast Reconstruction ◽

Smooth Muscle Actin ◽

Inflammatory Cells ◽

Tissue Growth ◽

Control Group ◽

Residual Volume ◽

Inflammatory Reactions ◽

Group 3 ◽

Dermal Matrices ◽

Acellular Dermal

Background Acellular dermal matrices (ADMs) have become an essential material for implant-based breast reconstruction. No previous studies have evaluated the effects of sterility of ADM under conditions of radiation. This study compared sterile (irradiated) and aseptic (non-irradiated) ADMs to determine which would better endure radiotherapy.Methods Eighteen male Balb/C mice were assigned to the control group with no irradiation (group 1) or one of two other groups with a radiation intensity of 10 Gy (group 2) or 20 Gy (group 3). Both sterile and aseptic ADMs were inserted into the back of each mouse. The residual volume of the ADM (measured using three-dimensional photography), cell incorporation, α-smooth muscle actin expression, and connective tissue growth factor expression were evaluated. The thickness and CD3 expression of the skin were measured 4 and 8 weeks after radiation.Results In groups 2 and 3, irradiated ADMs had a significantly larger residual volume than the non-irradiated ADMs after 8 weeks (P<0.05). No significant differences were found in cell incorporation and the amount of fibrosis between irradiated and non-irradiated ADMs. The skin was significantly thicker in the non-irradiated ADMs than in the irradiated ADMs in group 3 (P<0.05). CD3 staining showed significantly fewer inflammatory cells in the skin of irradiated ADMs than in non-irradiated ADMs in all three groups after 4 and 8 weeks (P<0.05).Conclusions Under radiation exposure, irradiated ADMs were more durable, with less volume decrease and less deposition of collagen fibers and inflammatory reactions in the skin than in non-irradiated ADMs.

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