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Outcomes in Implant-Based Breast Reconstruction Utilizing Biosynthetic Mesh: A Meta-Analysis.
Alisa Arnautovic1, Sonya Williams2, Makenna Ash2
1Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Aesthetic Surgery Journal
|January 7, 2025
Summary
Biosynthetic mesh offers a safe and cost-effective option for breast reconstruction, showing low complication rates. This meta-analysis supports considering these meshes as an alternative to acellular dermal matrices (ADM) for improved outcomes.
Area of Science:
- Plastic Surgery
- Oncology
- Biomaterials
Background:
- Biosynthetic mesh is increasingly used in breast cancer reconstruction for soft tissue support.
- It serves as an alternative to acellular dermal matrix (ADM).
Purpose of the Study:
- To investigate biosynthetic mesh options for breast reconstruction.
- To analyze associated complications and outcomes.
- To compare these with acellular dermal matrices (ADM).
Main Methods:
- Systematic review of PubMed, MEDLINE, and Embase.
- Meta-analysis of 24 studies (2167 breasts) on six mesh types (TIGR, Vicryl, PDO, TiLOOP, Durasorb, Galaflex).
- PRISMA guidelines followed; heterogeneity assessed using Q and I2 statistics.
Main Results:
- Pooled complication rates: seroma (5.26%), hematoma (2.5%), skin necrosis (5.5%), infection (4.8%), implant loss (3.85%).
- Low overall complication rates observed across various biosynthetic meshes.
- Differences in mesh characteristics noted, but generally favorable outcomes.
Conclusions:
- Biosynthetic meshes demonstrate safety and a significant cost advantage.
- They offer a potential decrease in short-term complications compared to ADM.
- Consideration of biosynthetic meshes is recommended for breast reconstruction.
