Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network...

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Surgical Complications

Background:

• Acellular dermal matrix (ADM) is often used in breast reconstruction but is expensive and associated with complications.
• Synthetic meshes are a common alternative to ADM.
• Limited comparative evidence exists for different breast reconstruction material substitutes.

Purpose of the Study:

• To compare complication rates between different materials used in breast reconstruction.
• To evaluate the efficacy of synthetic meshes versus ADM in reducing complications.
• To conduct a network meta-analysis of breast reconstruction materials.

Main Methods:

• Systematic review of studies published between 2010 and 2021.
• Inclusion of studies reporting complications such as infection, seroma, major complications, or contracture.
• Network meta-analysis comparing four categories: ADM, absorbable mesh, nonabsorbable mesh, and no mesh used.

Main Results:

• Infection rates were higher with ADM compared to both absorbable and nonabsorbable synthetic meshes.
• Seroma rates were significantly lower with synthetic meshes (OR 0.2 for absorbable, 0.1 for nonabsorbable) compared to ADM.
• No significant differences were found in major complication or contracture rates between the groups.

Conclusions:

• Synthetic meshes demonstrate lower rates of infection and seroma compared to ADM in breast reconstruction.
• Current evidence suggests synthetic meshes are a viable alternative to ADM regarding specific complications.
• Further research is recommended to investigate aesthetic outcomes and conduct direct comparisons between synthetic mesh types.