PRS AAPS Oral Proofs 2016
Katherine B. Santosa, MD,* Katelyn G. Bennett, MD,* Ji Qi, MS,* Hyungjin M. Kim, ScD,* Jennifer B. Hamill, MPH,* Andrea L. Pusic, MD, MHS,† Adeyiza O. Momoh, MD,* Edwin G. Wilkins, MD, MS*
From the *University of Michigan, Ann Arbor, Mich.; and †Memorial Sloan-Kettering Cancer Center, New York, N.Y.
PURPOSE: Acellular dermal matrix (ADM) has allowed for significant advances in immediate breast reconstruction. With its increasingly widespread use, different types have become available. In a single-center, retrospective cohort study, we previously demonstrated important outcome differences across brands of ADM. Specifically, patients reconstructed with FlexHD had higher rates of major infection than those with AlloDerm. In this study, we used a multicenter, prospective cohort to compare complication rates across common types of ADM.
METHODS: With patients recruited from 11 sites, we compared complications of immediate reconstructions using AlloDerm, FlexHD, and other products (ie, AlloMax, SERI Scaffold, SurgiMend, Biodesign, and Vicryl). Complications including hematoma, seroma, mastectomy flap necrosis, wound infection, wound dehiscence, and reconstructive failure were analyzed using hierarchical logistic regression models, accounting for study centers and controlling for a range of demographic and clinical variables.
RESULTS: Of the 810 patients included in our cohort, 507 patients (62.6%) were reconstructed with AlloDerm, 128 patients (15.8%) with FlexHD, and 175 patients (21.6%) with another type of material (ie, AlloMax, SERI Scaffold, Biodesign, SurgiMend, or Vicryl). Patients with FlexHD were significantly more likely to suffer an infection [odds ratio (OR), 2.79; 95% confidence interval (CI), 1.07–7.26; P = 0.036], reconstructive failure (OR, 3.3; 95% CI, 1.40–7.56; P = 0.006), and any complication (OR, 2.80; 95% CI, 1.63–4.80; P = 0.000) than those patients reconstructed with AlloDerm.
CONCLUSIONS: Patients undergoing immediate implant-based breast reconstruction with FlexHD had significantly increased odds of developing infection, reconstructive failure, and any sort of complication compared with those reconstructed with AlloDerm.