Lessons Learned from Three Different Acellular Dermal Matrices in Direct-to-Implant Breast Reconstruction

作     者：Claas Spengler Roland Mett Frank Masberg Peter M. Vogt Tobias R. Mett Claas Spengler;Roland Mett;Frank Masberg;Peter M. Vogt;Tobias R. Mett

作者机构：Department of Plastic Reconstructive Aesthetic Surgery HELIOS Klinik Schwerin Schwerin Germany Department of Plastic Aesthetic Hand and Reconstructive Surgery Hannover Medical School Hannover Germany 

出 版 物：《Modern Plastic Surgery》 (现代整形外科（英文）)

年 卷 期：2021年第11卷第1期

页      面：22-35页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Breast Reconstruction Acellular Dermal Matrix ADM Direct-to-Implant DTI Immediate Breast Reconstruction IBR Breast Cancer Skin Sparing Mastectomy EPIFLEX Strattice BRAXON 

摘      要：The aim of the study was to show significant differences regarding postoperative complications and outcomes using three different Acellular Dermal Matrices (ADM), namely Epiflex®, Strattice® and Braxon®, in immediate implant-based subpectoral breast reconstruction cases. Background: The use of Acellular Dermal Matrices for implant-based breast reconstruction cases continues to evolve. There is a wide variety of products which differ significantly in their biological features. It remains unclear if and how these differences manifest in clinical practice. Methods: 82 cases of primary breast reconstruction in the Department of Plastic and Aesthetic Surgery of HELIOS Clinics Schwerin, Germany between 2010 and 2018 were analyzed. 25 patients received Strattice® acellular dermal matrix (SADM), 22 cases Epiflex® acellular dermal matrix (EADM) and the remaining 35 cases Braxon® acellular dermal matrix (BADM). The mean follow-up was 1.8 years. Cases were analyzed regarding minor or major complications and rate of capsular contracture grade III or IV (Baker Classification). Results: The overall complication rate was 34.1% for all groups (SADM = 40%, EADM = 50%, BADM = 20%, p-value = 0.051). Of all cases, 6 patients underwent implant exchange or secondary autologous reconstruction due to capsular contracture (7.3%). The mean time between revision due