Immediate prepectoral breast reconstruction using bovine pericardium matrix

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Biomaterials in Medicine

Background:

• Immediate, implant-based breast reconstruction is increasingly popular using prepectoral placement and biologic matrices.
• Bovine pericardium matrix (Tutotmesh) and laser-assisted indocyanine green angiography (ICG-A) for skin flap perfusion assessment are less studied.
• This study evaluates the use of bovine pericardium matrix in prepectoral breast reconstruction.

Purpose of the Study:

• To assess the outcomes and complications of immediate prepectoral breast reconstruction using bovine pericardium matrix.
• To evaluate the utility of laser-assisted indocyanine green angiography (ICG-A) in reducing post-surgical complications.
• To identify risk factors associated with complications in this patient cohort.

Main Methods:

• Retrospective analysis of 81 prepectoral direct-to-implant breast reconstructions using bovine pericardium matrix from July 2019 to June 2021.
• Complications were recorded using the Clavien-Dindo classification.
• Multivariate logistic regression was employed to analyze postsurgical complications and identify significant predictors.

Main Results:

• The overall complication rate was 38.2%, with 14.3% requiring reoperation and 3.7% experiencing implant loss.
• Previous breast surgery was significantly associated with skin necrosis (p = 0.020).
• Increasing patient age correlated with an increased risk of implant rotation (p = 0.010).

Conclusions:

• Bovine pericardium matrix demonstrates favorable outcomes in prepectoral breast reconstruction.
• Careful patient selection is critical for optimizing results.
• ICG-A is a valuable tool for mitigating post-surgical complications.