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A Meta-analysis Assessing Postsurgical Outcomes between Aseptic and Sterile AlloDerm Regenerative Tissue Matrix
David Macarios1, Leah Griffin1, Abhishek Chatterjee1
1LifeCell, an Acelity Company, Bridgewater, N.J.; Acelity, San Antonio, Tex.; Divisions of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania Hospital, Philadelphia, Pa.; and Department of Plastic Surgery, Georgetown University, Washington, D.C.
Background:
AlloDerm, a human acellular dermal matrix, is available in a ready-to-use (RTU) or freeze-dried (FD) form. A limited number of studies have compared complication rates between RTU and FD in implant-based breast reconstruction. The objective of this report was to conduct a meta-analysis of previously reported complication rates between RTU and FD.
Methods:
A systematic literature review was conducted from 2010 to 2014 and supplemented by hand searches. Included studies compared both RTU and FD. Odds ratios and relative risks (RRs) with 95% confidence interval (CI), taking into account study heterogeneity, were calculated. Studies reporting patient-level results as opposed to breast-level results were excluded from the primary analysis but included in subsequent sensitivity analyses. Variable follow-up time within and between studies was also considered in a sensitivity analysis.
Results:
Of the 275 identified studies, 115 studies were eligible for detailed review. Only 5 studies compared RTU with FD, and of these, 2 studies had breast-level data and 1 study had patient-level data appropriate for meta-analysis. The 2 studies included in the primary meta-analysis had a pooled sample size: n = 116 RTU and n = 109 FD patients, or 205 and 186 breasts, respectively. Age and body mass index were similar between groups. Across all meta-analyses, there were no differences in complication rates between RTU and FD: cellulitis (RR = 0.863; 95% CI, 0.272-2.740), seroma (RR = 0.553; 95% CI, 0.026-11.830), and explantation (RR = 0.593; 95% CI, 0.247-1.425). Results remained nonsignificant even after adjustment for variable follow-up time.
Conclusion:
The results suggest that there are no differences in complication rates between RTU and FD forms.
