title: Complication prevalence following use of tutoplast-derived human acellular dermal matrix in prosthetic breast reconstruction: a retrospective review of 203 patients.
abstract: Use of human acellular dermal matrix (ADM) during prosthetic breast reconstruction has increased. Several ADM products are available produced by differing manufacturing techniques. It is not known if outcomes vary with different products. This study reports the complication prevalence following use of a tutoplast-derived ADM (T-ADM) in prosthetic breast reconstruction. We performed a retrospective chart review of 203 patients (mean follow-up times 12.2 months) who underwent mastectomy and immediate prosthetic breast reconstruction utilizing T-ADM, recording demographic data, surgical indications and complication (infection, seroma, hematoma, wound healing exceeding three weeks and reconstruction failure). During a four-year period, 348 breast reconstructions were performed Complications occurred in 16.4% of reconstructed breasts. Infection occurred in 6.6% of breast reconstructions (3.7% - major infection, requiring intravenous antibiotics and 2.9% minor infection, requiring oral antibiotics only). Seromas occurred in 3.4% and reconstruction failure occurred in 0.6% of breast reconstructions. Analysis suggested that complication prevalence was significantly higher in patients with a BMI >30 (p = 0.03). The complication profile following T-ADM use is this series is comparable to that reported for with other ADM products. T-ADM appears to be a safe and acceptable option for use in ADM-assisted breast reconstruction.
authors.affiliation: Division of Plastic Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: V L M
authors.initials: VL
authors.lastname: Rundell
authors.affiliation: Division of Plastic Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Beck
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA; The Center for Clinical Research Informatics, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Wang
authors.affiliation: Department of Plastic Surgery, Ohio State University School of Medicine, Columbus, OH, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Gutowski
authors.affiliation: Division of Plastic Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Sisco
authors.affiliation: Division of Plastic Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: G
authors.initials: G
authors.lastname: Fenner
authors.affiliation: Division of Plastic Surgery, NorthShore University HealthSystem, Evanston, IL, USA. Electronic address: mhoward@northshore.org.
authors.forename: M A
authors.initials: MA
authors.lastname: Howard
mesh_terms: D062088:Acellular Dermis / Q000009:adverse effects*; D000328:Adult; D019928:Breast Implantation / Q000009:adverse effects* / Q000379:methods; D002481:Cellulitis / Q000453:epidemiology; D003286:Contracture / Q000453:epidemiology; D005260:Female; D006801:Humans; D010793:Phthalazines; D012189:Retrospective Studies; D049291:Seroma / Q000453:epidemiology; D015625:Tissue Expansion Devices
chemical_list: D010793:Phthalazines; C020976:azelastine
keywords: Acellular dermal matrix; Breast reconstruction; Complications; Nipple sparing mastectomy