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Dermal matrix influence on the aesthetic outcome and complications of implant-based breast reconstructions: a matched cohort study
Eliana F.R. Duraes; Isis Scomacao; Sagar Rambhia; Rachel Aliotta; Risal Djohan; Steven Bernard; Andrea Moreira; Graham Schwarz
Cleveland Clinic
2018-02-15
Presenter: Sagar Rambhia
Affidavit:
I certify the project represents original work of the residents and authors on this project
Director Name: Steven Bernard
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: To compare surgical complications and aesthetic outcomes after implant-based breast reconstruction with and without dermal matrix (ADM) use.
METHODS: Implant based breast reconstruction patients were matched according to the year of surgery (±2 years), surgeon, age (±10 years), and laterality. The following groups were analyzed: direct to implant with ADM (Group 1), two stages without ADM (Group 2), and two stages with ADM (Group 3). Post-operative photos were graded by a four-member panel blinded for the reconstructive modality using a multi-parameter breast-specific aesthetic scale. The overall appearance grade was given in a 5-point scale.
RESULTS: Each group had 50 patients, originally. Post-operative photos were available for 28(56%), 18(36%), and 24(48%) patients for groups 1-3, respectively. There was no difference in rate of complications neither on the original groups nor on the ones with photos: 26(52%); 28(56%); and 24(48%) (p=0.726); and 15(41.7%); 8(22.2%); and 13(36.1%) (p=0.789), respectively. The rate of radiation therapy was higher among patients with photos from group 2: 4(23.5%); 9(52.9%); and 4(23.5%) (p=0.013); even though the original groups had similar radiation rates: 10(23.8%); 17(40.5%); and 15 (35.7%) (p=0.275). The overall appearance was higher for groups 1 and 3: 3.96±0.91; 3.15±1.14; and 3.80±0.75 (p=0.022).
CONCLUSION: Implant-based breast reconstruction aesthetic results were better in the groups using dermal matrix. The use of the dermal matrix did not increase the rate of complications
