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Prospective unbiased experience with three acellular dermal matrices in breast reconstruction
Author(s) -
Chang Edward I.,
Liu Jun
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24656
Subject(s) - medicine , seroma , breast reconstruction , mastectomy , surgery , prospective cohort study , implant , mammaplasty , demographics , tissue expander , breast cancer , cancer , complication , demography , sociology
Background The use of acellular dermal matrix (ADM) has become the standard of care in breast reconstruction. However, the majority of current studies are biased or combine large databases introducing inherent flaws. Here, we present a prospective single surgeon experience comparing three ADM. Methods All expander based breast reconstructions between 2014 and 2015 using ADM were included. Results Eighteen patients (32 breasts) underwent reconstruction using Flex Pliable, 15 patients (22 breasts) used Alloderm, and 14 patients (20 breasts) had Dermacell. There were no significant differences in patient demographics or comorbidities. All expanders were placed into a subpectoral position, and there were no direct to implant cases. Average intraoperative fill was comparable, (Flex: 225 cc, Alloderm: 180 cc, Dermacell: 130 cc). There were no differences in seroma, infection, or mastectomy skin flap necrosis rates. There were no cases of red breast, expander explanation or failed reconstruction in any cohort. Time to drain removal was significantly shorter in Flex and Dermacell patients compared to Alloderm (20 days vs 15 days vs 26 days, respectively; P = 0.01). Conclusions While there are differences between available ADM, successful outcomes can be achieved with proper patient selection, sound surgical technique, and diligent post‐operative management.