1131 Background: Acellular dermal matrices (ADM) are biological meshes of dermal origin (allo- or xenografts) stripped of all cellular components leaving a structurally intact and immunologically inert extracellular matrix. They are currently in use as adjunctive subdermal scaffolding during implant breast reconstruction to optimise aesthetic outcome. Despite current use in clinical practice there is no prospective data on their clinical efficacy, associated complication rates and cost-benefit analysis. These are the endpoints of our pilot cohort series, intended to provide baseline event rates to help power a multi-centre prospective, phase II, outcomes cohort study. Methods: From July 2011 to January 2012 and with our institution review board's approval - 20 consecutive patients undergoing immediate, implant breast reconstruction were prospectively accrued to the study. Primary endpoints: 30-day complication rates; Secondary endpoints: cosmetic outcome and cost-benefit analysis. Indications for mastectomy included therapeutic intent and/or risk reduction. The ADM used in all cases was SurgiMend PRS (TEI Bioscience Inc. Boston, MA). Results: Preliminary 30 day complication rates are in keeping with peer reviewed estimates for implant based breast reconstruction. Sub-set analysis of cosmetic outcome and cost-benefit ratio's are currently pending. In overview, ADM's appear to deliver the aesthetic benefit of autologous- implant cover (eg. latissimus dorsi myocutaneous flap) without the downside of donorsite morbidity and prolonged in-patient admission. Conclusions: This is to our knowledge the only prospectively accrued dataset seeking to critically evaluate the clinical efficacy, cost-benefit value and enhanced aesthetic utillity of ADMs (SurgiMend PRS) in the immediate breast reconstruction setting. The early results provide new evidence in support of the use ADMs in breast reconstruction and validate our intention to extend the study to a multicentre trial.
Nerve Preservation and Allografting for Sensory Innervation Following Immediate Implant Breast Reconstruction
