title: The effect of acellular dermal matrix use on complication rates in tissue expander/implant breast reconstruction.
abstract: Tissue expander/implant breast reconstructions by 5 surgeons at a single institution from 2005 to 2008 were retrospectively identified and divided into 2 cohorts: use of acellular dermal matrix (ADM, n = 75) versus standard submuscular placement (n = 52). The ADM group had a statistically significant higher rate of infection (28.9% vs. 12.0%, P = 0.022), reoperation (25.0% vs. 8.0%, P = 0.011), expander explantation (19.2% vs. 5.3%, P = 0.020), and overall complications (46.2% vs. 22.7%, P = 0.007). When stratifying by breast size, a higher complication rate was not observed with the use of ADM in breasts less than 600 g, whereas ADM use in breasts larger than 600 g was associated with a statistically significant higher rate of infection when controlling for the occurrence of skin necrosis. The ADM cohort had a significantly higher mean initial tissue expander fill volume (256 mL vs. 74 mL, P < 0.001) and a significantly higher mean initial tissue expander fill ratio (49% vs. 17%, P < 0.001). Further work is needed to define the ideal patient population for ADM use in tissue expander/implant breast reconstruction.
authors.affiliation: Stony Brook University School of Medicine, Stony Brook, NY, USA.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Lanier
authors.forename: Eric D
authors.initials: ED
authors.lastname: Wang
authors.forename: John J
authors.initials: JJ
authors.lastname: Chen
authors.forename: Balvant P
authors.initials: BP
authors.lastname: Arora
authors.forename: Steven M
authors.initials: SM
authors.lastname: Katz
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gelfand
authors.forename: Sami U
authors.initials: SU
authors.lastname: Khan
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Dagum
authors.forename: Duc T
authors.initials: DT
authors.lastname: Bui
mesh_terms: D001672:Biocompatible Materials; D019928:Breast Implantation / Q000379:methods*; D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D015625:Tissue Expansion Devices; D016896:Treatment Outcome
chemical_list: C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen