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The Effect of Acellular Dermal Matrix Use on Complication Rates in Tissue Expander/Implant Breast Reconstruction

Lanier, Steven T. BA, BS*; Wang, Eric D. BS*; Chen, John J. PhD; Arora, Balvant P. MD; Katz, Steven M. MD; Gelfand, Mark A. MD; Khan, Sami U. MD; Dagum, Alexander B. MD; Bui, Duc T. MD

doi: 10.1097/SAP.0b013e3181dba892
Clinical Papers: Northeastern Society of Plastic Surgeons
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Tissue expander/implant breast reconstructions by 5 surgeons at a single institution from 2005 to 2008 were retrospectively identified and divided into 2 cohorts: use of acellular dermal matrix (ADM, n = 75) versus standard submuscular placement (n = 52). The ADM group had a statistically significant higher rate of infection (28.9% vs. 12.0%, P = 0.022), reoperation (25.0% vs. 8.0%, P = 0.011), expander explantation (19.2% vs. 5.3%, P = 0.020), and overall complications (46.2% vs. 22.7%, P = 0.007). When stratifying by breast size, a higher complication rate was not observed with the use of ADM in breasts less than 600 g, whereas ADM use in breasts larger than 600 g was associated with a statistically significant higher rate of infection when controlling for the occurrence of skin necrosis. The ADM cohort had a significantly higher mean initial tissue expander fill volume (256 mL vs. 74 mL, P < 0.001) and a significantly higher mean initial tissue expander fill ratio (49% vs. 17%, P < 0.001). Further work is needed to define the ideal patient population for ADM use in tissue expander/implant breast reconstruction.

From the *Stony Brook University School of Medicine, Stony Brook, NY; and †Departments of Preventive Medicine and ‡Surgery, Division of Plastic and Reconstructive Surgery, Stony Brook University Medical Center, Stony Brook, NY.

Received February 25, 2010, and accepted for publication, March 2, 2010.

The authors have no conflict of interest to disclose and do not have any sources of funding to acknowledge.

Presented at the 26th Annual Meeting of the Northeastern Society of Plastic Surgeons, Charleston, SC, September 2009.

Reprints: Duc T. Bui, MD, Division of Plastic and Reconstructive Surgery, SUNY Stony Brook, Health Sciences Center, T-19 Rm 060, Stony Brook, NY 11794–8191. E-mail: dbui@notes.cc.sunysb.edu.

© 2010 Lippincott Williams & Wilkins, Inc.