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Improving Cost-efficiency in Bilateral Direct-to-Implant Reconstructions with Acellular Dermal Matrix
Javier Buendía1, Jesus Olivas-Menayo2
1Department of Plastic and Reconstructive Surgery, Hospital Clínico San Carlos, Madrid, Spain.
Plastic and Reconstructive Surgery. Global Open
|January 17, 2020
Summary
This study introduces a cost-effective bilateral breast reconstruction technique using one acellular dermal matrix (ADM) unit. This method reduces complications and improves implant coverage, making reconstruction more affordable and efficient.
Area of Science:
- Plastic Surgery
- Biomaterials Science
Background:
- Bilateral breast reconstruction rates are rising, partly due to BRCA mutation detection and prophylactic mastectomies.
- Acellular dermal matrix (ADM) is increasingly used, but its high cost is a significant limitation.
- Existing techniques often require multiple ADM units, increasing expenses and potential complications.
Purpose of the Study:
- To present a novel technique for bilateral breast reconstruction utilizing a single unit of acellular dermal matrix (ADM).
- To demonstrate a cost-effective and efficient method for ADM application in bilateral breast reconstruction.
- To evaluate the potential of this technique in reducing common post-reconstruction complications.
Main Methods:
- A musculofascial pocket is created using pectoralis major, serratus, and rectus fascia.
- A single ADM unit is divided into two halves (vertically or diagonally) based on pocket distensibility.
- The ADM halves are used to cover implants in bilateral breast reconstruction, sutured to the pocket edges.
Main Results:
- The technique allows for bilateral breast reconstruction using only one ADM unit, significantly reducing material cost.
- Improved implant coverage and reduced foreign body load are achieved.
- Potential reduction in complications like seroma, rippling, wrinkling, and implant visibility.
Conclusions:
- This single-unit ADM technique offers a more cost-effective solution for bilateral breast reconstruction.
- The method potentially enhances aesthetic outcomes and patient satisfaction by minimizing complications.
- Faster integration and reduced foreign body burden are anticipated with the use of a single ADM unit.
