scholarly journals An Initial Experience and Usefulness of Porcine Acellular Dermal Matrix (PADM) Assisted Prepectoral Breast Implant Surgery: Case Series and Systematic Review

2021 ◽  
Author(s):  
Woo Jin Song ◽  
Hyung Bo Sim ◽  
Hyun Gyo Jeong ◽  
Sang Gue Kang
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Breast Implant ◽  
Group Analysis ◽  
Acellular Dermal Matrix ◽  
Complication Rates ◽  
Dermal Matrix ◽  
Implant Surgery ◽  
Porcine Acellular Dermal Matrix ◽  
Acellular Dermal

Abstract Background: We report our experience with performing prepectoral placement breast implant surgery using Supporix TM (HansBiomed, Korea), a porcine acellular dermal matrix (PADM), for cosmetic and reconstructive indications. The clinical efficiency, safety, and cost-effectiveness of PADM were also discussed. Methods: A single-center, retrospective study was designed from December 2017 to December 2019. The participants were Korean female patients who had PADM-assisted prepectoral breast implant surgery performed by two surgeons (S.G.K. & H.B.S.). All complications were registered and analyzed. A systematic review and meta-analysis of the complication rates after PADM-assisted prepectoral breast implant surgery were conducted for comparison with other studies. Subgroup analysis was performed in three groups according to the operation type: the cosmetic breast surgery (CBS) group, the immediate implant-based breast reconstruction (IIBR) group, and the delayed implant-based breast reconstruction (DIBR) group. Results: A total of 20 breasts in 16 patients were included in our study with a median follow-up period of 8.25 months. In a systematic review, 20 publications with a total of 2,504 breasts in 1,921 females were quantitively analyzed. The overall complication rates in our study and other studies were 14% and 24% in total group analysis, 0% and 12% in the CBS group, 62% and 26% in the IIBR group, and 0% and 28% in the DIBR group, respectively.Conclusion: Our data support the effectiveness of PADM-assisted prepectoral breast implant surgery, which was comparable to other studies. PADM was effective for reducing seroma and hematoma in the revision CBS group and the DIBR group. In the IIBR group, it was helpful in preventing implant loss and explantation.

Prosthetic-Based Breast Reconstruction

2020 ◽  
Author(s):  
Jonathan Nguyen ◽  
Justin Williams ◽  
Albert Losken
Keyword(s):  
Breast Reconstruction ◽  
Breast Implant ◽  
Tissue Expander ◽  
Acellular Dermal Matrix ◽  
Large Cell ◽  
Fat Grafting ◽  
Immediate Reconstruction ◽  
Dermal Matrix ◽  
Prosthetic Reconstruction ◽  
Acellular Dermal

Prosthetic reconstruction is the most popular option for breast reconstruction after mastectomy. There are several different techniques, such as prepectoral versus subpectoral placement, and delayed versus immediate reconstruction, each with their own sets of risks and benefits. With the advent of improved implant technology, acellular dermal matrix, and fat grafting, prepectoral direct to implant has become an accepted and increasingly popular method of reconstruction, with similar to improved complication rates and outcomes as traditional staged tissue expander reconstruction. Prosthetic reconstruction has had some recent controversies, including breast implant associated anaplastic large cell lymphoma and breast implant illness, and many future studies are being directed towards these topics. This review contains 5 figures, and 53 references. Keywords: breast reconstruction, breast implant, acellular dermal matrix, prepectoral reconstruction, tissue expander, fat grafting, capsular contracture, immediate reconstruction, breast implant associated anaplastic large cell lymphoma, breast implant illness

scholarly journals Does Acellular Dermal Matrix Thickness Affect Complication Rate in Tissue Expander Based Breast Reconstruction?

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jessica F. Rose ◽  
Sarosh N. Zafar ◽  
Warren A. Ellsworth IV
Keyword(s):  
Breast Reconstruction ◽  
Skin Necrosis ◽  
Tissue Expander ◽  
Retrospective Chart Review ◽  
Acellular Dermal Matrix ◽  
Complication Rates ◽  
Dermal Matrix ◽  
Drain Removal ◽  
Dermal Matrices ◽  
Acellular Dermal

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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