Local reaction to FlexHD® acellular dermal matrix in breast reconstruction: A case report and review of the literature

Since its first reported use for the treatment of burns victims, acellular dermal matrix (ADM) use has expanded to surgeries including repairing thoracic and abdominal wall defects, and breast reconstruction. FlexHD® is a brand of ADM prepared from human cadaveric dermis that has been processed to remove antigenic components and is used to reinforce the subpectoral pocket created during submuscular breast implant surgery. Recent documentation of a phenomenon termed ‘red breast syndrome’ (RBS) has emerged in the medical literature, with little known about its aetiology and treatment. This paper presents a case of blistering cutaneous erythema from FlexHD® ADM.

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Prosthetic-Based Breast Reconstruction

10.2310/ps.10088 ◽

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

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What happens to an acellular dermal matrix after implantation in the human body? A histological and electron microscopic study

European Journal of Histochemistry ◽

10.4081/ejh.2018.2873 ◽

2018 ◽

Cited By ~ 11

Author(s):

Martin Boháč ◽

Ľuboš Danišovič ◽

Ján Koller ◽

Jana Dragúňová ◽

Ivan Varga

Keyword(s):

Connective Tissue ◽

Breast Reconstruction ◽

Breast Implant ◽

Lymphatic Vessels ◽

Acellular Dermal Matrix ◽

Giant Cells ◽

Electron Microscopic ◽

Dermal Matrix ◽

Acellular Matrix ◽

Acellular Dermal

Acellular matrices are used for various purposes and they have been studied extensively for their potential roles in regenerating tissues or organs. The acellular matrix generates physiological cues that mimic the native tissue microenvironment. Acellular dermal matrix (ADM) is a soft connective tissue graft generated by a decellularization process that preserves the intact extracellular skin matrix. Upon implantation, this structure serves as a scaffold for donor-side cells to facilitate subsequent incorporation and revascularization. In breast reconstruction, ADM is used mainly for lower pole coverage and the shaping of a new breast. It helps control the positioning of the implant in the inframammary fold, and prevent the formation of contractile pseudocapsule around the breast implant. In this study, we provide a comprehensive histological description of ADM used for human breast reconstruction over the course of several months following implementation. Using immunohistochemical methods (a panel of 12 antibodies) coupled with optical and transmission electron microscopy, we confirmed that the original acellular dermal matrix became recolonized by fibroblasts and myofibroblasts, and also by various other free cells of the connective tissue (lymphocytes, macrophages and multinucleated giant cells, granulocytes, mast cells) after implantation into the patient’s body. Within the implanted ADM, there was a relatively rapid ingrowth of blood vessels. Lymphatic vessels were only detected in one case 9 months after the implantation of the ADM. These results suggest that lymphangiogenesis is a longer process than angiogenesis.

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The Use of DermACELL Acellular Dermal Matrix in Oncologic Breast Reconstruction: A Retrospective Cohort Study and Systematic Review of the Literature

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2021.08.036 ◽

2021 ◽

Vol 233 (5) ◽

pp. e12-e13

Author(s):

Austin R. Swisher ◽

Mark J. Landau ◽

Nikita Kadakia ◽

Stephanie W. Holzmer ◽

Hahns Y. Kim

Keyword(s):

Systematic Review ◽

Cohort Study ◽

Breast Reconstruction ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Acellular Dermal Matrix ◽

Review Of The Literature ◽

Dermal Matrix ◽

Acellular Dermal

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Economic Analysis and Review of the Literature on Implant-Based Breast Reconstruction With and Without the Use of the Acellular Dermal Matrix

Aesthetic Plastic Surgery ◽

10.1007/s00266-013-0213-2 ◽

2013 ◽

Vol 37 (6) ◽

pp. 1194-1201 ◽

Cited By ~ 25

Author(s):

Jonathan Bank ◽

Nicole A. Phillips ◽

Julie E. Park ◽

David H. Song

Keyword(s):

Economic Analysis ◽

Breast Reconstruction ◽

Acellular Dermal Matrix ◽

Review Of The Literature ◽

Dermal Matrix ◽

Acellular Dermal

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

10.21203/rs.3.rs-420953/v1 ◽

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.

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Acellular Dermal Matrix (Permacol®) for Heterologous Immediate Breast Reconstruction after Skin-Sparing Mastectomy in Patients with Breast Cancer: A Single-Institution Experience and a Review of the Literature

Frontiers in Medicine ◽

10.3389/fmed.2016.00072 ◽

2017 ◽

Vol 3 ◽

Cited By ~ 2

Author(s):

Laura Knabben ◽

Gowthami Kanagalingam ◽

Sara Imboden ◽

Andreas R. Günthert

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Acellular Dermal Matrix ◽

Immediate Breast Reconstruction ◽

Review Of The Literature ◽

Single Institution ◽

Dermal Matrix ◽

Acellular Dermal

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The Comparison of Breast Reconstruction Using Two Types of Acellular Dermal Matrix after Breast-Conserving Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10153430 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3430

Author(s):

Jeongshin An ◽

Hyungju Kwon ◽

Woosung Lim ◽

Byung-In Moon ◽

Nam Sun Paik

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Acellular Dermal Matrix ◽

Breast Conserving Surgery ◽

The Body ◽

Surgical Time ◽

Dermal Matrix ◽

Specimen Weight ◽

Breast Shape ◽

Acellular Dermal

Breast reconstruction during breast-conserving surgery (BCS) can improve the breast shape. This study introduces breast reconstruction in BCS with two types of acellular dermal matrix (ADM). The study included 134 patients who underwent BCS due to breast cancer from February 2018 to May 2021. This study was conducted by one surgeon, and is the result of a three-year study. The patient group who underwent BCS using ADM was mainly targeted at patients with minor to severe defects after the operation. The average age of the patients was 51.8 years, and the body mass index (BMI) was 23.8 kg/m. The specimen weight was 30–120 g. The average surgical time, including reconstruction, was 100.4 min, combined with reconstruction. There were minor complications in six patients. The advantage of using ADM is that it can quickly correct the shape of the breast after conventional BCS surgery. Pellet-type ADM, rather than sheet-type, can create a breast shape similar to that before surgery. Breast reconstruction using ADM can be an easy and convenient method for making a better shape from BCS.

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