| The use of acellular dermal matrix in immediate two-stage tissue expander breast reconstruction. | |
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MedLine Citation:
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PMID: 22544088 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Acellular dermal matrix is commonly used in implant-based breast reconstruction to allow for quicker tissue expansion with better coverage and definition of the lower pole of the breast. This study was performed to analyze complications associated with its use in immediate two-stage, implant-based breast reconstruction and to subsequently develop guidelines for its use. METHODS: A retrospective analysis of 628 consecutive immediate two-stage tissue expander breast reconstructions at a single institution over a 3-year period was conducted. The reconstructions were divided into two groups: reconstruction with acellular dermal matrix and reconstruction without it. Demographic information, patient characteristics, surface area of acellular dermal matrix, and complications were analyzed and compared. RESULTS: A total of 407 patients underwent 628 immediate two-stage, implant-based breast reconstructions; 442 reconstructions (70.3 percent) used acellular dermal matrix and 186 (29.6 percent) did not. The groups had similar patient characteristics; however, major complications were significantly increased in the acellular dermal matrix group (15.3 versus 5.4 percent; p = 0.001). These complications included infection requiring intravenous antibiotics (8.6 versus 2.7 percent; p = 0.001), flap necrosis requiring excision (6.7 versus 2.7 percent; p = 0.015), and explantation of the tissue expander (7.7 versus 2.7 percent; p = 0.004). CONCLUSIONS: Use of acellular dermal matrix in immediate two-stage, implant-based breast cancer reconstruction is associated with a significant increase in major complications. Therefore, it should only be used in specific patients and in minimal amounts. Indications for its use include single-stage permanent implant reconstruction and inadequate local muscle coverage of the tissue expander. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. |
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Authors:
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Katie E Weichman; Stelios C Wilson; Andrew L Weinstein; Alexes Hazen; Jamie P Levine; Mihye Choi; Nolan S Karp |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Plastic and reconstructive surgery Volume: 129 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-04-30 Completed Date: 2012-06-25 Revised Date: 2012-09-10 |
Medline Journal Info:
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Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1049-58 Citation Subset: AIM; IM |
Affiliation:
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New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, NY, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Breast Implantation / adverse effects* Breast Implants / adverse effects Breast Neoplasms / prevention & control, surgery* Collagen / adverse effects*, therapeutic use Female Humans Mammaplasty / adverse effects*, methods Mastectomy* Middle Aged Retrospective Studies Tissue Expansion / adverse effects* Tissue Expansion Devices / adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Alloderm; 9007-34-5/Collagen |
| Comments/Corrections | |
Comment In:
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Plast Reconstr Surg. 2012 May;129(5):1059-60
[PMID:
22544089
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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