Summary
Tissue expander or permanent implant coverage in postmastectomy breast reconstruction
is often challenging. Multiple authors have demonstrated the use of acellular cadaveric
dermis (ACD) in nonexpansive, single-stage breast reconstruction. The literature also
suggests that tissue expansion may be accomplished with ACD as well for stage reconstructions.
In many cases tissue expansion is necessary to create a submuscular and subACD pocket
to accommodate a subsequent permanent prosthesis. In this study we report the outcomes
and complication rates of using ACD in staged breast reconstruction. We reviewed the
charts of 41 patients (65 breasts) in whom ACD was used in staged reconstructions.
We analysed the patients' charts and operative records to determine postoperative
complication rates and results. Complication rates for wound infection, expander removal,
haematoma, and seroma were: 3.1% (two of 65), 1.5% (one of 65), 1.5% (one of 65),
and 4.6% (three of 65), respectively. The use of ACD in expansive postmastectomy breast
reconstruction has an extremely low complication rate, results in good cosmetic outcome,
and should be in the repertoire of plastic surgeons. Further follow up is needed to
evaluate the long term outcomes of ACD use in postmastectomy breast reconstruction.
Keywords
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References
- The transverse rectus abdominis musculocutaneous free flap: a reliable alternative for delayed autologous tissue breast reconstruction.Ann Plast Surg. 1990; 25: 425-434
- Immediate breast reconstruction in breast cancer: morbidity and outcome.Am Surg. 1998; 64: 1195-1199
- One hundred free DIEP flap breast reconstructions: a personal experience.Br J Plast Surg. 1999; 52: 104-111
- Breast reconstruction.Cancer. 1994; 74: 376-380
- Aesthetic breast reconstruction using a combination of free transverse rectus abdominis musculocutaneous flaps and breast implants.Ann Plast Surg. 1996; 37: 258-264
- Implant reconstruction in breast cancer patients treated with radiation therapy.Plast Reconstr Surg. 2006; 117: 359-365
- Aesthetic aspects of breast reconstruction.Aesthetic Plast Surg. 1982; 6: 61-67
- Complete one-stage, immediate breast reconstruction with prosthetic material in patients with large or ptotic breasts.Plast Reconstr Surg. 2002; 110 ([discussion 494–6]): 487-493
- Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings.Ann Plast Surg. 2005; 55: 232-239
- Nonexpansive immediate breast reconstruction using human acellular tissue matrix graft (AlloDerm).Ann Plast Surg. 2006; 57: 1-5
- Implant breast reconstruction using acellular dermal matrix.Ann Plast Surg. 2006; 56: 22-25
- 20: immediate breast reconstruction with tissue expanders and alloderm.Plast Reconstr Surg. 2006; 118: 18
- Radiation therapy as a cause of capsular contraction.Ann Plast Surg. 1994; 32: 342-345
- Infectious complications following breast reconstruction with expanders and implants.Plast Reconstr Surg. 2003; 112: 467-476
- Revascularization of human acellular dermis in full thickness abdominal wall reconstruction in the rabbit model.Ann Plast Surg. 2003; 50: 523-527
- Intracapsular allogenic dermal grafts for breast implant related problems.Plast Reconstr Surg. 2003; 112: 1692-1696
- Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair.Ann Plast Surg. 2004; 52: 188-194
- Surgical treatment of pseudosyndactyly of the hand in epidermolysis bullosa: histological analysis of an acellular allograft dermal matrix.Ann Plast Surg. 1998; 41: 503-507
- Dermal autografts for fascial repair after TRAM flap harvest.Plast Reconstr Surg. 1998; 102: 2287-2292
- Vaginal paravaginal repair with an alloderm graft.Am J Obstet Gynecol. 2003; 189 ([discussion 1618–9]): 1612-1618
- Chest wall reconstruction with acellular dermal matrix (Alloderm) and a latissimus muscle flap.Plast Reconstr Surg. 2004; 114: 1015-1017
- Use of alloderm implant to prevent Frey Syndrome after parotidectomy.Arch Facial Plast Surg. 2003; 5: 109-112
Article info
Publication history
Published online: April 25, 2007
Accepted:
March 13,
2007
Received:
October 9,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
