title: A Complication Analysis of 2 Acellular Dermal Matrices in Prosthetic-based Breast Reconstruction.
abstract: BACKGROUND
  Acellular dermal matrices (ADM) are now routine in postmastectomy prosthetic-based breast reconstruction. The goal of the current study was to compare the complications of 2 ADM products-AlloDerm and Cortiva.
  
  
  METHODS
  A retrospective analysis of prosthetic-based breast reconstruction in Atlanta, Ga., over 5 years. Inclusion criteria were the use of the ADM types (AlloDerm or Cortiva) and use of a tissue expander or implant. Statistical analysis compared group demographics, risk factors, and early complications.
  
  
  RESULTS
  Of the 298 breast reconstructions, 174 (58.4%) used AlloDerm and 124 (41.6%) used Cortiva. There was no difference in overall complication frequency (16 AlloDerm and 18 Cortiva; P = 0.195). Within specific categories, there was a difference in mastectomy skin flap necrosis, but, based on further regression analysis, this was attributable to differences in body mass index (P = 0.036). Furthermore, there were no differences in the rates of infection (6 AlloDerm and 5 Cortiva; P = 1.0), seroma/hematoma (9 AlloDerm and 7 Cortiva; P = 1.0), or drain duration (13.2 day AlloDerm and 14.2 day Cortiva, P = 0.2). By using a general estimating equation for binomial logistical regression, it was found that only current tobacco use (P = 0.033) was a significant predictor for a complication. Trending predictors were body mass index (P = 0.074) and age (P = 0.093). The type of matrix was not a significant predictor for any of the recorded complication (P = 0.160).
  
  
  CONCLUSIONS
  Although AlloDerm is well established, we have shown that Cortiva has an equivalent complication frequency. Future work will focus on long-term outcome measures and histological evaluation of vascularization and integration.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Atlanta, Ga.; and Private Practice, Atlanta, Ga.
authors.forename: Orion P
authors.initials: OP
authors.lastname: Keifer
authors.affiliation: Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Atlanta, Ga.; and Private Practice, Atlanta, Ga.
authors.forename: Eugenia K
authors.initials: EK
authors.lastname: Page
authors.affiliation: Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Atlanta, Ga.; and Private Practice, Atlanta, Ga.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hart
authors.affiliation: Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Atlanta, Ga.; and Private Practice, Atlanta, Ga.
authors.forename: Randall
authors.initials: R
authors.lastname: Rudderman
authors.affiliation: Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Atlanta, Ga.; and Private Practice, Atlanta, Ga.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Carlson
authors.affiliation: Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Atlanta, Ga.; and Private Practice, Atlanta, Ga.
authors.forename: Albert
authors.initials: A
authors.lastname: Losken