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Alloplastic adjuncts in breast reconstruction.

Miguel S Cabalag1, Marie Rostek1, George S Miller1

  • 11 Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria 3199, Australia ; 2 Monash University Plastic and Reconstructive Surgery Unit (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia ; 3 Department of Surgery, Townsville Hospital, School of Medicine and Dentistry, James Cook University Clinical School, Townsville, Queensland 4814, Australia.

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|April 6, 2016
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Summary
This summary is machine-generated.

Acellular dermal matrices (ADMs) show promise in single-stage breast reconstruction, offering better outcomes and cost-effectiveness. However, ADM-assisted two-stage reconstruction yields inferior results compared to non-ADM methods.

Keywords:
Breast reconstructionacellular dermal matrices (ADMs)alloplastic implantsbreast implants

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Area of Science:

  • Plastic Surgery
  • Biomaterials Science
  • Oncology

Background:

  • Acellular dermal matrices (ADMs) and synthetic meshes are increasingly used in breast reconstruction.
  • Limited comparative data exists for various alloplastic adjuncts, challenging surgeon selection.
  • This review evaluates outcomes, cost-effectiveness, and radiotherapy impact of alloplastic adjuncts.

Purpose of the Study:

  • To systematically review and evaluate outcomes of alloplastic adjuncts in post-mastectomy breast reconstruction.
  • To assess the cost-effectiveness of different alloplastic adjuncts.
  • To analyze outcomes in patients who received radiotherapy.

Main Methods:

  • Systematic review adhering to PRISMA 2009 statement.
  • Searched Ovid MEDLINE, Embase, PubMed, and Cochrane Library.
  • Included 89 articles reporting on alloplastic adjuncts in breast reconstruction.

Main Results:

  • Literature predominantly focuses on ADMs; synthetic mesh data is scarce.
  • ADM use in single-stage reconstruction showed lower complication rates and better cost-effectiveness.
  • ADM-assisted two-stage reconstruction generally had inferior outcomes compared to non-ADM methods.
  • ADMs may reduce capsular contracture rates; effects in irradiated tissue are varied.

Conclusions:

  • ADM-assisted two-stage breast reconstruction is associated with poorer outcomes than non-ADM use.
  • Alloplastic adjuncts may be beneficial in single-stage, direct-to-implant breast reconstruction.
  • Further high-level studies are needed to compare long-term outcomes and identify optimal alloplastic adjuncts.