title: Initial experience with the use of foetal/neonatal bovine acellular dermal collagen matrix (SurgiMend™) for tissue-expander breast reconstruction.
abstract: BACKGROUND
  Acellular dermal matrix (ADM) is commonly used in staged breast reconstruction using tissue expanders (TEs). The literature on human ADM has reported variable outcomes, and there is a paucity of data for xenogenic sources of ADM. The aim of this study is to evaluate the early complications, risk factors and outcomes using SurgiMend™ in staged breast reconstruction.
  
  
  METHODS
  An Institutional Review Board (IRB)-approved, retrospective analysis of a single surgeon's experience was performed. From August 2009 to May 2011, 65 patients underwent staged breast reconstruction using 95 sheets of SurgiMend™. The nominal TE fill volume was 383 ± 83 cc (range 250-550), mean intra-operative fill volume was 148 ± 86 cc (range 0-350) and mean final fill volume was 413 ± 176 cc (range 100-800). The mean clinic follow-up time was 16.9 ± 8.7 months; mean age was 50.9 ± 11.7 years; and average body mass index (BMI) was 26.0 ± 5.5 kg m(-2). Correlation with risk factors and clinical outcomes were analysed.
  
  
  RESULTS
  The incidences of postoperative complications were: haematoma 3.2%, seroma 7.5% and re-operation due to infection 2.1%. Age, diabetes mellitus, and hypertension had a significant correlation with an increased overall complication rate. With respect to early complications, such as infection requiring re-operation, diabetes demonstrated a trend with an odds ratio of 11.69.
  
  
  CONCLUSIONS
  This study demonstrates that the use of SurgiMend™ is associated with low early complication rates and is well tolerated in staged breast reconstruction.
authors.affiliation: The Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Rika
authors.initials: R
authors.lastname: Ohkuma
authors.forename: Kate J
authors.initials: KJ
authors.lastname: Buretta
authors.forename: Raja
authors.initials: R
authors.lastname: Mohan
authors.forename: Gedge D
authors.initials: GD
authors.lastname: Rosson
authors.forename: Ariel N
authors.initials: AN
authors.lastname: Rad
mesh_terms: D062088:Acellular Dermis / Q000706:statistics & numerical data*; D000328:Adult; D000818:Animals; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002417:Cattle; D015331:Cohort Studies; D016001:Confidence Intervals; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016015:Logistic Models; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: ADM; BMI; Bovine acellular dermal matrix; Breast reconstruction; CDC; Centers for Disease Control; ETO; IMF; IRB; Institutional Review Board; SurgiMend™; TE; acellular dermal matrix; body-mass index; ethylene oxide; inframammary fold; tissue expander