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Enhanced Performance of Dual-Port Tissue Expanders with Use of Acellular Dermal Matrix
Christina R. Kuhrau, BA; Kiersten C. Woodyard De Brito, MD MPH; Kelly Spiller, MD; Douglas R. Dembinski, MD; Ryan M. Gobble, MD
University of Cincinnati
2025-01-10
Presenter: Christina Kuhrau
Affidavit:
Christina Kuhrau
Director Name: Dr. Ann Schwentker
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Complications following tissue expander (TE) placement for staged oncologic breast reconstruction remain a challenge. Innovations such as dual-port TEs with both filling and drainage ports mitigate seroma risk. The purpose of this study was to compare outcomes between dual and single-port TEs with acellular dermal matrix (ADM), a bioengineered graft.
Methods: Retrospective chart review was completed for patients who underwent TE breast reconstruction by a single surgeon between January 2018 and November 2023. Demographics, cancer treatments, and outcomes were collected. Analysis included descriptive statistics, F-distribution tests, Welch's t-tests, Chi-squared, and Fisher Exact tests.
Results: 154 breasts were included: 118 single-port TEs (74 with ADM, 62.7%) and 36 dual-port TEs (11 with ADM, 31.0%). Premature explant was needed for 15.3% of single-port and 28.5% of dual-port TEs (p=0.328). Explant in both groups was due to infection, wound healing problems, rupture, and seroma. However, premature explant of dual-port TEs occurred predominantly without ADM (p=0.0075), contrasting single-port TEs where ADM use showed no significant difference in explant rate. Infection occurred more often in dual-port expanders without ADM (p=0.0071), whereas single-port TE infection trended higher with ADM.
Conclusion: In this cohort, ADM appears protective when used with dual-port TEs. It is possible that ADM's homogenous surface safeguards the drain port from clogging with subcutaneous fat or other tissue, decreasing risk of fluid collection and infection. Routine ADM use with dual-port TEs could reduce complications and improve patient outcomes.
