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Postsurgical Outcomes Between Three Types of AlloDerm Regenerative Tissue Matrix

Anna Widmyer, MD Ryan Lucero, MD Douglas Wagner, MD
Summa Health
2016-02-01

Presenter: Anna Widmyer

Affidavit:
I certify that the material has not been published before and is entirely the work of above mentioned authors

Director Name: Douglas Wagner

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Background: Acellular dermal matrix is commonly used in implant-based reconstruction. It has been shown to decrease the incidence of capsular contracture, allows greater initial fill volumes and the ability to go direct to implant. The purpose of this study is to compare postoperative complication rates between freeze-dried aseptic AlloDerm, prehydrated, terminally sterilized AlloDerm RTU and perforated AlloDerm RTU in immediate implant based reconstruction.

Methods: Restrospective chart review of a single surgeon's experience with implant based reconstruction utilizing acellular dermal matrix. Charts were reviewed from all implant based reconstructions from January 2009 through December 2015. All recorded complications were reviewed including infection, seroma, hematoma, skin necrosis, implant exposure and return to operating room for management of complications.

Results: A total of 331 consecutive implant based reconstructions were identified. Of these, freeze-dried aseptic AlloDerm was used in 151 breasts (45.6%), terminally sterilized AlloDerm RTU was used in 104 breasts (31.4%) and perforated AlloDerm RTU was used in 76 breasts (22.9%). The overall complication rate was 31.4%, reoperation rate 12% with the complication rates from each group being 33.8% for the freeze-dried aseptic AlloDerm, 36.5% for the AlloDerm RTU and 19.7% for the perforated AlloDerm RTU. The most common complication was infection 22% followed by seroma 12% and skin edge necrosis 9%.

Conclusions: Postsurgical outcomes of sequentially used freeze-dried aseptic AlloDerm, prehydrated, terminally sterilized AlloDerm RTU and perforated AlloDerm RTU for implant-based breast reconstruction were reviewed and found to be reasonably low and improving over time.

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