title: Analysis of clinically significant seroma formation in breast reconstruction using acellular dermal grafts.
abstract: With a rise in tissue expander-based breast reconstructions (TEBRs) using acellular dermal matrix (ADM), we have seen an increase in ADM-specific complications. In this study, we aimed to evaluate clinically significant seroma (CSS) formation-defined by the need for a drainage procedure-to determine if there was a difference in incidence between product types: AlloDerm (AL), DermaMatrix (DM), and FlexHD (FHD). This was a retrospective review of consecutive patients who underwent TEBR at a single institution. The total number of reconstructed breasts was separated into the following 4 groups according to the product type: AL, DM, FHD, or no ADM. We identified the total number of CSSs and compared these data between product types. A logistic regression was performed in an attempt to identify independent risk factors associated with seroma formation. In total, we identified 284 consecutive TEBRs. Overall, there were 17 (7.7%) seromas in 220 breast reconstructions in which ADM was used. When comparing the number of CSS between groups-AL (n = 2, 4.0%), DM (n = 6, 5.4%), FHD (n = 9, 14.75%), and no ADM (n = 1, 1.5%)-we found a significant difference in seroma incidence between product types (P = 0.016). Multivariate analysis identified a strong trend toward FHD as an independent predictor of seroma formation (P = 0.061). Our review suggests that there is strong trend in CSS formation with the use of FHD as compared to other product types and reconstructions in which no ADM was used.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
authors.forename: Brett F
authors.initials: BF
authors.lastname: Michelotti
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brooke
authors.forename: John
authors.initials: J
authors.lastname: Mesa
authors.forename: Matthew Z
authors.initials: MZ
authors.lastname: Wilson
authors.forename: Kurtis
authors.initials: K
authors.lastname: Moyer
authors.forename: Donald R
authors.initials: DR
authors.lastname: Mackay
authors.forename: Rogerio I
authors.initials: RI
authors.lastname: Neves
authors.forename: John
authors.initials: J
authors.lastname: Potochny
mesh_terms: D062088:Acellular Dermis / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery; D003094:Collagen / Q000009:adverse effects*; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D016462:Mammaplasty / Q000295:instrumentation / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D049291:Seroma / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D015626:Tissue Expansion / Q000295:instrumentation; D015625:Tissue Expansion Devices; D016896:Treatment Outcome
chemical_list: C440568:Alloderm; C582618:FlexHD; D003094:Collagen