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Acellular dermal matrix reduces capsule formation in two-stage breast reconstruction
Karan Chopra1,2, Bryan Buckingham1, Jamil Matthews1
1Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
International Wound Journal
|August 16, 2016
Summary
Acellular dermal matrix (ADM) placement in two-stage breast reconstruction significantly reduces capsule formation. Using ADM lowers implant-associated capsule thickness and inflammation compared to native tissue.
Area of Science:
- Plastic Surgery
- Regenerative Medicine
- Biomaterials Science
Background:
- Acellular dermal matrix (ADM) is utilized in two-stage breast reconstruction to create tissue expander pockets.
- Capsule formation around implants is a common complication, potentially leading to adverse outcomes.
Purpose of the Study:
- To evaluate if using ADM during the initial stage of breast reconstruction reduces capsular contracture at the time of implant exchange.
Main Methods:
- A prospective study involving patients undergoing mastectomy and tissue expander reconstruction.
- Biopsies were taken from expander pockets adjacent to ADM and pectoralis muscle during implant exchange.
- Pathological analysis assessed capsule thickness and cellular composition.
Main Results:
- Capsule thickness was significantly lower where the expander contacted ADM (47.91 ± 110.82 µm) versus pectoralis muscle (782 ± 194 µm).
- ADM-contacting areas showed host tissue regeneration, including cell migration and angiogenesis.
- Pectoralis muscle-contacting areas exhibited a foreign body response with collagen deposition and myofibroblast presence.
Conclusions:
- ADM placement in the first stage of breast reconstruction effectively minimizes capsule thickness and the inflammatory foreign body response.
- ADM promotes a more favorable tissue response, indicating its benefit in improving outcomes for tissue expander-based breast reconstruction.
