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The biomechanical properties of meshed versus perforated acellular dermal matrices (ADM): Analysis of surface area and fluid egress

Katherine H. Carruthers, MD, MS, Pankaj Tiwari MD, Ergun Kocak MD, MS
West Virginia University
2020-01-07

Presenter: Katherine H. Carruthers, MD, MS

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. This project represents the original work of the resident.

Director Name: Aaron Mason, MD

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

Background
Acellular dermal matrices (ADMs) are routinely used for soft tissue augmentation, however the presence of seromas can inhibit product incorporation. As a result, ADM products are available in a variety of meshed or perforated forms. Because of the lack of consistency between manufacture designs, we set out to determine the fluid egress properties and the increase in surface area resulting from common cut patterns.

Methods
Three ADM cut patterns were studied: one meshed and two perforated. The surface area of these modified samples was calculated. Fluid was passed through each ADM and the amount of time required for fluid passage was recorded. An ANOVA was used to determine if there was a significant difference in egress properties across the three patterns.

Results
Meshing in a 1:1 pattern resulted in a 97.50% increase in surface area. In comparison, only a 0.30% increase resulted from Perforation Pattern #1 and a 0.59% increase resulted from Perforation Pattern #2. There was a significant difference in egress properties across the three cut patterns (p=0.000). The average egress time of Mesh Pattern #1 was 1.974 seconds, of Perforation Pattern #2 was 6.504 seconds, and of Perforation Pattern #1 was 10.369 seconds.

Conclusion
Quantitative comparison revealed that meshing ADM tissue improves fluid egress properties and increases the surface area compared to ADM tissue perforated at levels typically available on the market. Therefore, the use of meshed ADM tissue could improve the ability of the product to incorporate with the recipient, resulting in improved patient outcomes.

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