Outcomes of Acellular Dermal Matrix Use in Radiated Implant-based Breast Reconstruction: A Systematic Review and...

Area of Science:

• Plastic Surgery
• Oncology
• Biomaterials

Background:

• Acellular dermal matrix (ADM) improves outcomes in implant-based breast reconstruction.
• Outcomes are inconsistent in patients receiving postmastectomy radiotherapy (PMRT) due to fibrosis and vascular compromise.
• This meta-analysis examines complication rates of ADM in irradiated implant-based reconstruction.

Purpose of the Study:

• To evaluate complication rates associated with acellular dermal matrix (ADM) use in irradiated implant-based postmastectomy breast reconstruction.
• To compare outcomes based on ADM type, implant placement plane, and radiotherapy timing.
• To identify factors influencing complication rates in this patient population.

Main Methods:

• PRISMA-guided literature search for studies on ADM-assisted, irradiated breast reconstruction.
• Proportional meta-analysis of eligible studies.
• Subgroup analyses based on ADM type, implant placement plane, and radiotherapy timing.

Main Results:

• Pooled complication rates: 16.8% capsular contracture, 8.3% infection, 5.8% seroma, 10.6% implant loss.
• Prepectoral placement showed lower capsular contracture and infection rates.
• Postoperative PMRT was associated with higher rates of capsular contracture and implant loss; preoperative PMRT had the lowest rates.
• Bovine ADM demonstrated lower complication rates; porcine ADM showed favorable satisfaction.

Conclusions:

• ADM-assisted reconstruction in irradiated patients has variable complication rates.
• ADM type, implant plane, and radiotherapy timing significantly influence outcomes.
• Preoperative radiation and bovine ADM are associated with more favorable outcomes.