title: Tissue expander breast reconstruction using prehydrated human acellular dermis.
abstract: BACKGROUND
  Human acellular dermal matrices help facilitate immediate tissue expander-implant breast reconstruction by providing support to the inferolateral pole, improving control of implant position, and enhancing early volume expansion. Although several freeze-dried human acellular dermal products have demonstrated reasonable safety and efficacy in immediate tissue expander-implant breast reconstruction, no dedicated studies have evaluated clinical outcomes of prehydrated human acellular dermal matrix (PHADM) in breast reconstruction.
  
  
  METHODS
  The outcomes of 121 consecutive tissue expander reconstructions performed by the senior author using PHADM were evaluated.
  
  
  RESULTS
  Mean intraoperative tissue expander fill volume was 256.6 ± 133 mL, 60% of final expander volume. Patients required an average of 3.2 additional expansions prior to tissue expander-to-implant exchange. Mean follow-up period after reconstruction was 44 ± 26.5 weeks. Complications occurred in 20 (16.5%) breasts, including 9 (7.4%) soft-tissue infections, 8 (6.6%) partial mastectomy flap necroses, and 2 (1.7%) seromas. Eleven (9.1%) breasts ultimately required explantation. Patients receiving radiation demonstrated a strong trend toward greater complications (30.8% vs. 13.7%, P = 0.0749).
  
  
  CONCLUSIONS
  The outcomes and complication rates of PHADM tissue expander breast reconstruction are comparable to those reported with freeze-dried human acellular dermis.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: Vinay
authors.initials: V
authors.lastname: Rawlani
authors.forename: Donald W
authors.initials: DW
authors.lastname: Buck
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Johnson
authors.forename: Kamaldeep S
authors.initials: KS
authors.lastname: Heyer
authors.forename: John Y S
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000008:administration & dosage*; D003094:Collagen / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D015625:Tissue Expansion Devices
chemical_list: C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen