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

Modern Plastic Surgery 2021年第1期11卷 22-35页

作者： Claas Spengler Roland Mett Frank Masberg Peter M. Vogt Tobias R. Mett Department of Plastic Reconstructive Aesthetic Surgery HELIOS Klinik Schwerin Schwerin Germany Department of Plastic Aesthetic Hand and Reconstructive Surgery Hannover Medical School Hannover Germany

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 to capsular contracture and reconstruction was

关键词： Breast Reconstruction Acellular Dermal Matrix ADM Direct-to-Implant DTI Immediate Breast Reconstruction IBR Breast Cancer Skin Sparing Mastectomy epiflex Strattice BRAXON

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