title: Infectious complications associated with the use of acellular dermal matrix in implant-based bilateral breast reconstruction.
abstract: BACKGROUND
  The use of acellular dermal matrix (ADM) has become a routine practice in implant-based breast reconstruction. Bilateral mastectomy is becoming more popular in cases of unilateral breast cancer. ADM has been associated with an increased incidence of complications.
  
  
  METHODS
  We identified cases of bilateral implant-based breast reconstruction over a 5-year period. Data collection included medical comorbities, details of operative management, and details of postoperative cancer treatment.
  
  
  RESULTS
  On univariate analysis, the use of ADM (31% vs. 7%, P = 0.018), smoking (37% vs. 13%, P = 0.045), and open wound (55% vs. 13%, P = 0.006) were significantly associated with increased risk of infection. Multivariate analysis revealed open wound as the strongest predictor of infection.
  
  
  CONCLUSIONS
  The use of ADM is associated with an increased risk of infection in bilateral implant-based breast reconstruction. However, it does not appear to be an independent risk factor by itself.
authors.affiliation: Division of Plastic Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Hill
authors.forename: Lesley
authors.initials: L
authors.lastname: Wong
authors.forename: Pamela
authors.initials: P
authors.lastname: Kemper
authors.forename: Jason
authors.initials: J
authors.lastname: Buseman
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Davenport
authors.forename: Henry C
authors.initials: HC
authors.lastname: Vasconez
mesh_terms: D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects*; D019928:Breast Implantation / Q000295:instrumentation*; D020405:Dermis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*
chemical_list: D001672:Biocompatible Materials