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Comparison between Freeze-dried and Ready-to-use AlloDerm in Alloplastic Breast Reconstruction

Yuen, James C. MD*; Yue, Connie J. BA; Erickson, Stephen W. PhD; Cooper, Shannon APN*; Boneti, Cristiano MD§; Henry-Tillman, Ronda MD; Klimberg, Suzanne MD

Plastic and Reconstructive Surgery - Global Open: March 2014 - Volume 2 - Issue 3 - p e119
doi: 10.1097/GOX.0000000000000061
Original Articles
United States

Background: AlloDerm, a brand of acellular dermal matrix, is commonly used as an internal hammock to support the tissue expander or permanent implant in breast reconstruction. The aim of our study is to evaluate the complication rates associated with the freeze-dried (FD) AlloDerm and the ready-to-use (RTU) AlloDerm.

Methods: This institutional review board–approved retrospective study involved 103 patients who underwent immediate postmastectomy breast reconstructions from June 2011 to August 2012. The first 51 patients underwent 96 immediate breast reconstructions with FD AlloDerm. The subsequent 52 patients underwent 100 immediate breast reconstructions with RTU AlloDerm. Patient demographics, postoperative complication rates in study cohort, and complication rates stratified by body mass index (BMI) were analyzed.

Results: Multiple patient demographics in the 2 cohorts are closely matched (P > 0.05). RTU AlloDerm was associated with higher rates of seroma and cellulitis compared with FD AlloDerm (22.0% vs 18.8%, P = 0.599 and 21.0% vs 12.5%, P = 0.129, respectively). Significantly higher rates of seroma and cellulitis were found in patients with BMI ≥ 30 compared with BMI < 30 (34.5% vs 9.2%, P < 0.001 and 29.9% vs 6.4%, P < 0.001, respectively). A generalized linear mixed model shows that obesity and RTU AlloDerm are statistically significant predictors of cellulitis (adjusted odds ratio = 10.413, P < 0.001 and adjusted odds ratio = 3.712, P = 0.011, respectively).

Conclusions: Our study demonstrates a clinically higher postoperative complication rate in immediate breast reconstruction with RTU AlloDerm compared with FD AlloDerm and highlights the unfavorable risk factor correlation with significant obesity.

From the *Division of Plastic Surgery, University of Arkansas for Medical Sciences, Little Rock, Ark.; College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Ark.; Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Ark.; §Division of Plastic Surgery, University of Alabama, Birmingham, Ala.; and Division of Surgical Oncology, University of Arkansas for Medical Sciences, Little Rock, Ark.

Received for publication December 15, 2013; accepted January 13,2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.

James C. Yuen, MD Division of Plastic Surgery University of Arkansas for Medical Sciences Slot 720, 4301 West Markham Street Little Rock, AR 72205 E-mail: yuenjamesc@uams.edu

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© 2014 American Society of Plastic Surgeons