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Comparison of Different Acellular Dermal Matrices in Breast Reconstruction: The 50/50 Study

Pittman, Troy A. M.D.; Fan, Kenneth L. M.D.; Knapp, Andrew B.S.; Frantz, Shelby B.S.; Spear, Scott L. M.D.

Plastic & Reconstructive Surgery: March 2017 - Volume 139 - Issue 3 - p 521–528
doi: 10.1097/PRS.0000000000003048
Breast: Original Articles
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Background: Acellular dermal matrix has enjoyed extensive use in primary and secondary alloplastic breast aesthetic and reconstructive surgery. The objective of this study was to examine clinical outcomes between available acellular dermal matrix products: DermACELL (LifeNet Health, Virginia Beach, Va.) and AlloDerm Ready To Use (LifeCell Corp., Branchburg, N.J.).

Methods: A retrospective chart review was performed on 58 consecutive patients (100 breasts) reconstructed with either DermACELL (n = 30 patients; 50 breasts) or AlloDerm Ready To Use (n = 28 patients; 50 breasts). The mastectomies were performed by three different breast surgeons. All reconstructions were performed by the same plastic surgeon (T.A.P.). Statistical analysis was performed by means of Fisher’s exact test.

Results: Differences in the average age, body mass index, percentage having neoadjuvant/adjuvant chemotherapy or breast irradiation, and numbers of therapeutic and prophylactic mastectomies between the two groups were not statistically significant (p < 0.05). Complications in both cohorts of patients were clinically recorded for 90 days after immediate reconstruction. When comparing outcomes, patients in the DermACELL group had a significantly lower incidence of “red breast syndrome” (0 percent versus 26 percent; p = 0.0001) and fewer days before drain removal (15.8 days versus 20.6 days; p = 0.017). No significant differences were seen in terms of seroma, hematoma, delayed healing, infection, flap necrosis, or explantation.

Conclusion: Patients reconstructed with DermACELL as compared with AlloDerm Ready To Use have significantly decreased number of days to drain removal and red breast syndrome and equivalent rates of other complications, including seroma, infection, flap necrosis, and explantation.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Washington, D.C.

From the Department of Plastic Surgery, MedStar Georgetown University Hospital; Georgetown University School of Medicine; and private practice.

Received for publication March 9, 2016; accepted August 19, 2016.

Disclosure: Dr. Pittman is a consultant for MedTronic, Novadaq, and Sientra. Dr. Spear is a consultant for LifeCell, Allergan, Bonti, Motiva, and Novadaq. No funds were received or utilized for this research.

Troy A. Pittman, M.D., Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, D.C. 20007, troy.a.pittman@gunet.georgetown.edu

©2017American Society of Plastic Surgeons