TY - JOUR
T1 - Tissue expander breast reconstruction using prehydrated human acellular dermis
AU - Rawlani, Vinay
AU - Buck, Donald W.
AU - Johnson, Sarah A.
AU - Heyer, Kamaldeep S.
AU - Kim, John Y.S.
PY - 2011/6
Y1 - 2011/6
N2 - Introduction: Human acellular dermal matrices help facilitate immediate tissue expander-implant breast reconstruction by providing support to the inferolateral pole, improving control of implant position, and enhancing early volume expansion. Although several freeze-dried human acellular dermal products have demonstrated reasonable safety and efficacy in immediate tissue expander-implant breast reconstruction, no dedicated studies have evaluated clinical outcomes of prehydrated human acellular dermal matrix (PHADM) in breast reconstruction. Methods: The outcomes of 121 consecutive tissue expander reconstructions performed by the senior author using PHADM were evaluated. Results: Mean intraoperative tissue expander fill volume was 256.6 ± 133 mL, 60% of final expander volume. Patients required an average of 3.2 additional expansions prior to tissue expander-to-implant exchange. Mean follow-up period after reconstruction was 44 ± 26.5 weeks. Complications occurred in 20 (16.5%) breasts, including 9 (7.4%) soft-tissue infections, 8 (6.6%) partial mastectomy flap necroses, and 2 (1.7%) seromas. Eleven (9.1%) breasts ultimately required explantation. Patients receiving radiation demonstrated a strong trend toward greater complications (30.8% vs. 13.7%, P = 0.0749). Conclusions: The outcomes and complication rates of PHADM tissue expander breast reconstruction are comparable to those reported with freeze-dried human acellular dermis.
AB - Introduction: Human acellular dermal matrices help facilitate immediate tissue expander-implant breast reconstruction by providing support to the inferolateral pole, improving control of implant position, and enhancing early volume expansion. Although several freeze-dried human acellular dermal products have demonstrated reasonable safety and efficacy in immediate tissue expander-implant breast reconstruction, no dedicated studies have evaluated clinical outcomes of prehydrated human acellular dermal matrix (PHADM) in breast reconstruction. Methods: The outcomes of 121 consecutive tissue expander reconstructions performed by the senior author using PHADM were evaluated. Results: Mean intraoperative tissue expander fill volume was 256.6 ± 133 mL, 60% of final expander volume. Patients required an average of 3.2 additional expansions prior to tissue expander-to-implant exchange. Mean follow-up period after reconstruction was 44 ± 26.5 weeks. Complications occurred in 20 (16.5%) breasts, including 9 (7.4%) soft-tissue infections, 8 (6.6%) partial mastectomy flap necroses, and 2 (1.7%) seromas. Eleven (9.1%) breasts ultimately required explantation. Patients receiving radiation demonstrated a strong trend toward greater complications (30.8% vs. 13.7%, P = 0.0749). Conclusions: The outcomes and complication rates of PHADM tissue expander breast reconstruction are comparable to those reported with freeze-dried human acellular dermis.
KW - FlexHD
KW - acellular dermis
KW - breast reconstruction
KW - tissue expansion
UR - http://www.scopus.com/inward/record.url?scp=79958038180&partnerID=8YFLogxK
U2 - 10.1097/SAP.0b013e3181f3ed0a
DO - 10.1097/SAP.0b013e3181f3ed0a
M3 - Article
C2 - 21233698
AN - SCOPUS:79958038180
SN - 0148-7043
VL - 66
SP - 593
EP - 597
JO - Annals of Plastic Surgery
JF - Annals of Plastic Surgery
IS - 6
ER -