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Complications after Perforated versus Nonperforated Acellular Dermal Matrix Use in Direct-to-Implant Breast
Kasey Leigh Wood1, Ilana G Margulies1, Paul L Shay1
1Division of Plastic Surgery, Icahn School of Medicine at Mount Sinai, New York, N.Y.
Plastic and Reconstructive Surgery. Global Open
|June 16, 2020
Summary
Perforated acellular dermal matrices (P-ADMs) do not alter complication rates in direct-to-implant breast reconstruction compared to nonperforated types (NP-ADMs). This study found no significant differences in outcomes between P-ADM and NP-ADM use.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Biomaterials in Medicine
Background:
- Acellular dermal matrices (ADMs) are integral to direct-to-implant (DTI) breast reconstruction.
- Recent innovations include perforated ADMs (P-ADMs), with speculation they may reduce seroma formation.
Purpose of the Study:
- To compare complication rates between perforated (P-ADM) and nonperforated (NP-ADM) acellular dermal matrices in direct-to-implant breast reconstruction.
- To evaluate the impact of ADM perforation on postoperative complications.
Main Methods:
- Retrospective review of 364 patients (680 breasts) undergoing DTI breast reconstruction by a single surgeon (2011-2018).
- Propensity score matching was used to balance confounding variables between P-ADM and NP-ADM groups.
- Univariate analysis assessed the association between ADM type and postoperative complications.
Main Results:
- After matching, 294 breasts (147 P-ADM, 147 NP-ADM) were analyzed.
- Univariate analysis revealed no statistically significant association between ADM type (perforated vs. nonperforated) and any postoperative complication.
Conclusions:
- The complication profile of DTI breast reconstruction is not significantly affected by the use of P-ADM versus NP-ADM.
- Further multi-institution, prospective, randomized trials are recommended to enhance understanding of ADM type and clinical outcomes.
