Predictors of Complications and Comparison of Outcomes Using SurgiMend Fetal Bovine and AlloDerm Human Cadaveric Acellular Dermal Matrices in Implant-Based Breast Reconstruction.
BACKGROUND
Implant-based breast reconstruction with an acellular dermal matrix is one of the most common procedures performed by plastic surgeons. Although numerous matrices are available, there is little literature comparing them. This study compares the rates of complications between two commonly used products: AlloDerm (human cadaveric) and SurgiMend (fetal bovine) acellular dermal matrices.


METHODS
A retrospective review of a single center's 6-year experience was performed for consecutive, immediate breast reconstructions with acellular dermal matrix from 2009 to 2014. The authors compared demographics and surgical characteristics between patients receiving AlloDerm versus SurgiMend. Multivariate logistic regression was used to determine any association between type of matrix and surgical complications and to identify other clinical predictors for complications.


RESULTS
A total of 640 patients underwent 952 reconstructions using AlloDerm [578 breasts (61 percent)] or SurgiMend [374 breasts (39 percent)]. The average follow-up was 587 days. Multivariate analysis revealed that type of matrix was not an independent risk factor for the development of complications. However, smoking, age, radiotherapy, and initial tissue expander fill volume were associated with increased risk of postoperative complications.


CONCLUSIONS
Both AlloDerm and SurgiMend acellular dermal matrices demonstrate similar rates of major complications when used in immediate implant-based breast reconstruction. In contrast, preoperative radiation therapy, smoking, increasing age, and initial tissue expander fill volume are independent risk factors for postoperative complications. Reconstructive surgeons should take these findings into consideration when performing implant-based breast reconstruction with a dermal matrix.
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Joseph A
JA
Ricci
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Matthew D
MD
Treiser
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Ran
R
Tao
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Wei
W
Jiang
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Gretchen
G
Guldbrandsen
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Eric
E
Halvorson
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Charles A
CA
Hergrueter
Boston, Mass.|From Harvard Plastic Surgery Residency Program, the Division of Plastic Surgery, Department of Surgery, and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School.
Yoon S
YS
Chun
D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D000818:Animals; D019928:Breast Implantation / Q000295:instrumentation* / Q000379:methods; D002417:Cattle; D003094:Collagen; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
C440568:Alloderm; D003094:Collagen
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