A cohort analysis of early outcomes after AlloDerm, FlexHD, and SurgiMend use in two-stage prepectoral breast reconstruction Journal Article
| Authors: | Chu, J. J.; Nelson, J. A.; Kokosis, G.; Haglich, K.; McKernan, C. D.; Rubenstein, R.; Vingan, P. S.; Allen, R. J. Jr; Coriddi, M. R.; Dayan, J. H.; Disa, J. J.; Mehrara, B. J.; Matros, E. |
| Article Title: | A cohort analysis of early outcomes after AlloDerm, FlexHD, and SurgiMend use in two-stage prepectoral breast reconstruction |
| Abstract: | Background: Acellular dermal matrix (ADM) is frequently utilized in prepectoral breast reconstruction, but few studies have examined the role of ADM type in complication risk. Objectives: This study was performed to determine the impact of ADM type on early complication rates in 2-stage alloplastic prepectoral breast reconstruction. Methods: We performed a cohort examination of all patients who underwent mastectomy with immediate 2-stage alloplastic prepectoral breast reconstruction with ADM support at Memorial Sloan Kettering Cancer Center from 2018 to 2021. ADM types utilized included AlloDerm (LifeCell Corporation, Branchburg, NJ), FlexHD (MTF Biologics, Edison, NJ), and SurgiMend (Integra LifeSciences Corporation, Princeton, NJ). Complication rates based on the number of tissue expanders (TEs) were determined for each ADM type. Performance of multivariate logistic regression determined the impact of ADM type on complication risk after accounting for confounders. Results: Overall, 726 patients (1054 TEs: 194 AlloDerm, 93 FlexHD, 767 SurgiMend) were included. The 3 cohorts differed in terms of mastectomy type (nipple-sparing: 23.5% of AlloDerm, 33.3% of FlexHD, 19.1% of SurgiMend, P = .038); ADM perforation (perforated: 94.8% of AlloDerm, 98.2% of FlexHD, 100% of SurgiMend, P < .001); and ADM size (AlloDerm: 153.2 cm2 [37.6], SurgiMend: 198.7 cm2 [10.4], FlexHD: 223.7 cm2 [37.9], P < .001). On univariate examination, no differences existed between ADM types for seroma, infection, exposure, malposition, or TE loss. Additionally, after adjustment for confounders with multivariate regression, no ADM type had higher odds of TE loss. Conclusions: In this large cohort of prepectoral reconstruction patients, ADM type did not significantly affect the risk of complications. Additional prospective studies are warranted to better evaluate ADM choice for prepectoral breast reconstruction. © The Author(s) 2023. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. |
| Keywords: | adult; controlled study; middle aged; antibiotic agent; major clinical study; comparative study; sentinel lymph node biopsy; cohort analysis; breast reconstruction; graft necrosis; medical record review; retrospective study; postoperative complication; cancer center; surgical infection; postoperative infection; multivariate logistic regression analysis; hemispheric dominance; hematoma; seroma; nipple-sparing mastectomy; cellulitis; axillary lymph node dissection; clinical outcome; skin flap; human; female; article; breast tissue expander rotation; device malposition; implant complication; two stage prepectoral breast reconstruction |
| Journal Title: | Aesthetic Surgery Journal |
| Volume: | 43 |
| Issue: | 12 |
| ISSN: | 1090-820X |
| Publisher: | Oxford University Press |
| Date Published: | 2023-12-01 |
| Start Page: | 1491 |
| End Page: | 1498 |
| Language: | English |
| DOI: | 10.1093/asj/sjad246 |
| PUBMED: | 37551639 |
| PROVIDER: | scopus |
| PMCID: | PMC11184452 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Jonas A. Nelson -- Source: Scopus |
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