Biologic Response With and Without Acellular Dermal Matrix in Breast Reconstruction

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Wound Healing Research

Background:

• Acellular dermal matrices (ADMs) are biologic meshes used in implant-based breast reconstruction (IBBR).
• Capsular contracture is a common complication of IBBR, potentially influenced by inflammation.
• ADMs may mitigate capsular contracture by modulating the inflammatory response.

Purpose of the Study:

• To review evidence on inflammation's role in capsular contracture after IBBR without ADM.
• To explore mechanisms by which ADMs might reduce capsular contracture incidence in IBBR.

Main Methods:

• A narrative review of studies published up to December 31, 2023.
• Searches conducted in BIOSIS Previews, Embase, MEDLINE, and Northern Light Life Sciences Conference Abstracts.
• Keywords included "breast" and "capsular contracture."

Main Results:

• Identified factors predicting capsular contracture, including reconstruction type, collagen integrity, radiation therapy, implant surface, placement plane, incision, and complications like hematoma, seroma, infection, and biofilm.
• Reviewed emerging biomarkers for capsular contracture prediction (e.g., NRG1, IL-8, TIMP-1, MMP2, SAA1).
• Summarized evidence on ADM tissue integration, modulation of wound healing and inflammation, and decreased capsular contracture rates post-radiation therapy.

Conclusions:

• Acellular dermal matrices (ADMs) show potential in reducing capsular contracture rates in implant-based breast reconstruction.
• Evidence suggests ADMs modulate the inflammatory response and improve wound healing, thereby decreasing complication likelihood.