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Does Acellular Dermal Matrix Thickness Affect Complication Rate in Tissue Expander Based Breast Reconstruction?

Jessica F Rose¹, Sarosh N Zafar¹, Warren A Ellsworth Iv¹

¹Division of Plastic Surgery, Department of Surgery, Houston Methodist Hospital, Medical Office Building, 118400 Katy Freeway, Suite 500, Houston, TX 77094, USA.

Plastic Surgery International

|May 19, 2016

Summary

Thicker acellular dermal matrices (ADMs) may increase complication risks in breast reconstruction. Further studies are needed to confirm if ADM thickness impacts outcomes like infection and skin necrosis.

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Area of Science:

Plastic Surgery
Reconstructive Surgery
Biomaterials in Medicine

Background:

Acellular dermal matrices (ADMs) are utilized in breast reconstruction.
While beneficial, ADMs are linked to potential complications.
The impact of ADM thickness on these complications remains unclear.

Purpose of the Study:

To investigate the relationship between acellular dermal matrix (ADM) thickness and complication rates in breast reconstruction.
To identify specific complications potentially influenced by ADM thickness.

Main Methods:

Retrospective chart review of 77 tissue expander-based breast reconstructions using AlloDerm over 4 years.
Evaluation of preoperative factors and postoperative complications (seroma, hematoma, infection, skin necrosis, reintervention).
Analysis of ADM thickness and Jackson-Pratt (JP) drain removal time.

Main Results:

Higher complication rates were observed in the thicker ADM group.
Smokers had increased risk of skin necrosis (p < 0.0001).
Radiated breasts and higher BMI were associated with increased infection rates (p = 0.0085 and p = 0.0037, respectively).
Seroma was linked to prolonged JP drainage (p = 0.0004).

Conclusions:

A trend suggests thicker ADMs may correlate with increased complication rates in breast reconstruction.
Future prospective research focusing on ADM thickness is warranted to further elucidate its impact on outcomes.