title: Complication Rates With Human Acellular Dermal Matrices: Retrospective Review of 211 Consecutive Breast Reconstructions.
abstract: BACKGROUND
  Human acellular dermal matrix (HADM) is commonly used to provide coverage and support for breast reconstruction. The primary purpose of this study was to evaluate the complication rates associated with breast reconstruction procedures when performed in conjunction with multiple types of HADM in a consecutive series.
  
  
  METHODS
  After receiving institutional review board approval, medical records from a single surgeon were retrospectively reviewed for 126 consecutive patients (170 breasts and 211 procedures) who received a breast reconstruction or revision with implantation of HADM between 2012 and 2014. Patient demographics, surgical technique, and the complication profile of 4 major types of HADM were evaluated by procedure. Complication data were primarily evaluated for infection, seroma formation, necrosis, and other complications requiring additional surgery.
  
  
  RESULTS
  The total complication rate was 19.4%. The complication rates were not statistically different between all 4 types of HADM: Alloderm (n= 143); Alloderm RTU (n= 19); FlexHD (n= 18); hMatrix (n= 32) (P> 0.05). Smokers and large-breasted women (≥500 g) had a significantly higher complication rate than the rest of the population (P< 0.01 andP< 0.03, respectively). The complication rates associated with all other patient cohorts analyzed (age, body mass index, comorbid conditions, cancer diagnosis, prepectoral technique) showed no influence on complication rates (P> 0.05).
  
  
  CONCLUSIONS
  In characteristically similar cohorts, there was no statistically significant difference in complication rates based on type of HADM; however, certain risk factors and anatomy should be considered before HADM-assisted breast reconstruction.
authors.affiliation: Hague Center for Cosmetic and Plastic Surgery, Norfolk, Va.; Breast Care Specialists, PC, Norfolk, Va.; Medical College of Wisconsin, Milwaukee, Wis.; and Bacterin International, Inc., Belgrade, Mont.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Schnarrs
authors.affiliation: Hague Center for Cosmetic and Plastic Surgery, Norfolk, Va.; Breast Care Specialists, PC, Norfolk, Va.; Medical College of Wisconsin, Milwaukee, Wis.; and Bacterin International, Inc., Belgrade, Mont.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Carman
authors.affiliation: Hague Center for Cosmetic and Plastic Surgery, Norfolk, Va.; Breast Care Specialists, PC, Norfolk, Va.; Medical College of Wisconsin, Milwaukee, Wis.; and Bacterin International, Inc., Belgrade, Mont.
authors.forename: Chase
authors.initials: C
authors.lastname: Tobin
authors.affiliation: Hague Center for Cosmetic and Plastic Surgery, Norfolk, Va.; Breast Care Specialists, PC, Norfolk, Va.; Medical College of Wisconsin, Milwaukee, Wis.; and Bacterin International, Inc., Belgrade, Mont.
authors.forename: Serena A
authors.initials: SA
authors.lastname: Chase
authors.affiliation: Hague Center for Cosmetic and Plastic Surgery, Norfolk, Va.; Breast Care Specialists, PC, Norfolk, Va.; Medical College of Wisconsin, Milwaukee, Wis.; and Bacterin International, Inc., Belgrade, Mont.
authors.forename: Kerri A
authors.initials: KA
authors.lastname: Rossmeier