Complications in tissue expander breast reconstruction

A comparison of AlloDerm, DermaMatrix, and FlexHD acellular inferior pole dermal slings

Sebastian Brooke, John Mesa, Mehmet Uluer, Brett Michelotti, Kurtis Moyer, Rogerio Neves, Donald Mackay, John Potochny

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Acellular dermal matrix (ADM) is frequently used in tissue expander breast reconstruction (TEBR) for coverage of the inferior pole. Several published studies have suggested increased rates of complications with the use of ADM. It is unknown, however, if the type of ADM used for TEBR impacts complication rates. The aim of this study is to compare 3 different types of ADM for TEBR in regard to clinically significant complications, specifically infection. We performed a retrospective analysis of primary breast cancer-related TEBR with or without ADM. Exclusion criteria consisted of prior major breast surgery, inadequate data, or loss to follow-up. Reconstructions were grouped by dermal sling type, AlloDerm, DermaMatrix (DM), FlexHD (FHD), or no ADM. Complications included cellulitis, abscess, seroma, expander leak or puncture, skin necrosis, wound dehiscence, or hematoma. Those requiring admission to hospital or reoperation were considered significant. Of 284 breasts reconstructed, 49 used AlloDerm, 110 used DM, 62 used FHD, and 64 used no ADM. The total complication rate with AlloDerm was 22% [95% confidence interval (CI), 11-34], with DM was 15% (95% CI, 8-21), and with FHD was 18% (95% CI, 8-28) (P = 0.47). Infectious complication rates for AlloDerm, DM, and FHD were equal at 10% (P = 0.97). The total complication rate of all ADM reconstructions as a grouped cohort was 17% compared to 11% without ADM (P = 0.48). The overall incidence of infectious complications with ADM was 10% compared to 2% without ADM (P = 0.09). There is no difference in the clinically significant overall complication rate or incidence of infection between AlloDerm, DM, and FHD. Isolating infectious complications, there is a trend toward increased incidence with ADM compared to reconstructions without.

Original languageEnglish (US)
Pages (from-to)347-349
Number of pages3
JournalAnnals of plastic surgery
Volume69
Issue number4
DOIs
StatePublished - Oct 1 2012

Fingerprint

Acellular Dermis
Tissue Expansion Devices
Mammaplasty
Skin
Confidence Intervals
Alloderm
FlexHD
Incidence
Breast
Seroma
Cellulitis
Infection
Reoperation
Punctures

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

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title = "Complications in tissue expander breast reconstruction: A comparison of AlloDerm, DermaMatrix, and FlexHD acellular inferior pole dermal slings",
abstract = "Acellular dermal matrix (ADM) is frequently used in tissue expander breast reconstruction (TEBR) for coverage of the inferior pole. Several published studies have suggested increased rates of complications with the use of ADM. It is unknown, however, if the type of ADM used for TEBR impacts complication rates. The aim of this study is to compare 3 different types of ADM for TEBR in regard to clinically significant complications, specifically infection. We performed a retrospective analysis of primary breast cancer-related TEBR with or without ADM. Exclusion criteria consisted of prior major breast surgery, inadequate data, or loss to follow-up. Reconstructions were grouped by dermal sling type, AlloDerm, DermaMatrix (DM), FlexHD (FHD), or no ADM. Complications included cellulitis, abscess, seroma, expander leak or puncture, skin necrosis, wound dehiscence, or hematoma. Those requiring admission to hospital or reoperation were considered significant. Of 284 breasts reconstructed, 49 used AlloDerm, 110 used DM, 62 used FHD, and 64 used no ADM. The total complication rate with AlloDerm was 22{\%} [95{\%} confidence interval (CI), 11-34], with DM was 15{\%} (95{\%} CI, 8-21), and with FHD was 18{\%} (95{\%} CI, 8-28) (P = 0.47). Infectious complication rates for AlloDerm, DM, and FHD were equal at 10{\%} (P = 0.97). The total complication rate of all ADM reconstructions as a grouped cohort was 17{\%} compared to 11{\%} without ADM (P = 0.48). The overall incidence of infectious complications with ADM was 10{\%} compared to 2{\%} without ADM (P = 0.09). There is no difference in the clinically significant overall complication rate or incidence of infection between AlloDerm, DM, and FHD. Isolating infectious complications, there is a trend toward increased incidence with ADM compared to reconstructions without.",
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Complications in tissue expander breast reconstruction : A comparison of AlloDerm, DermaMatrix, and FlexHD acellular inferior pole dermal slings. / Brooke, Sebastian; Mesa, John; Uluer, Mehmet; Michelotti, Brett; Moyer, Kurtis; Neves, Rogerio; Mackay, Donald; Potochny, John.

In: Annals of plastic surgery, Vol. 69, No. 4, 01.10.2012, p. 347-349.

Research output: Contribution to journalArticle

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T2 - A comparison of AlloDerm, DermaMatrix, and FlexHD acellular inferior pole dermal slings

AU - Brooke, Sebastian

AU - Mesa, John

AU - Uluer, Mehmet

AU - Michelotti, Brett

AU - Moyer, Kurtis

AU - Neves, Rogerio

AU - Mackay, Donald

AU - Potochny, John

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