title: Successful breast reconstruction using acellular dermal matrix can be recommended in healthy non-smoking patients.
abstract: BACKGROUND
  We present Scandinavia's first series of immediate alloplastic breast reconstructions with an acellular dermal matrix.
  
  
  METHODS
  Data were collected retrospectively in 76 cases of immediate breast reconstruction using an acellular dermal matrix (ADM) and an implant.
  
  
  RESULTS
  A total of 59 women were reconstructed between June 2011 and January 2013. Cases included 42 unilateral and 17 bilateral reconstructions. A large number of patients had adjuvant therapy, hormone therapy (34), radiation therapy (27) or chemotherapy (38). The median age was 51 years (30-70 years) and the median follow-up period was 326 days (68-624 days). The co-morbidity factors included hypertension (n = 11), diabetes (n = 2) and 19 patients were smokers. Unsuccessful reconstructions counted ten cases (13%), eight of these due to necrosis and/or wound dehiscence (10%) and two due to infection (3%). The failure rate in non-smokers was 2/52 (4%) compared with 8/24 (33%) in smokers, p = 0.001. In hypertensive patients, the failure rate was 6/12 (50%) compared with 4/64 (6%)in normotensive patients, p = 0.001. 70% of the failed reconstructions occurred in patients older than 65 years of age.
  
  
  CONCLUSIONS
  Immediate alloplastic breast reconstruction using an ADM can be recommended to healthy non-smoking patients.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Plastikkirurgisk Afdeling Z, Vejle Sygehus, Kabbeltoft 25, 7100 Vejle, Denmark. jbth@dadlnet.dk.
authors.forename: Gudjon Leifur
authors.initials: GL
authors.lastname: Gunnarsson
authors.forename: Mikkel
authors.initials: M
authors.lastname: Børsen-Koch
authors.forename: Susanne
authors.initials: S
authors.lastname: Arffmann
authors.forename: Ivar
authors.initials: I
authors.lastname: Guldvog
authors.forename: Peter
authors.initials: P
authors.lastname: Wamberg
authors.forename: Christina
authors.initials: C
authors.lastname: Kjær
authors.forename: Tormod
authors.initials: T
authors.lastname: Westvik
authors.forename: Jørn Bo
authors.initials: JB
authors.lastname: Thomsen
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome