Early complications in prepectoral breast reconstructions with and without acellular dermal matrix: A preliminary analysis of outcomes Journal Article


Authors: Plotsker, E. L.; Graziano, F. D.; Rubenstein, R. N.; Haglich, K.; Allen, R. J. Jr; Coriddi, M. R.; Dayan, J. H.; Poulton, R.; McKernan, C.; Mehrara, B. J.; Matros, E.; Disa, J. J.; Nelson, J. A.
Article Title: Early complications in prepectoral breast reconstructions with and without acellular dermal matrix: A preliminary analysis of outcomes
Abstract: Background: Prepectoral tissue expander (TE) placement for two-stage postmastectomy reconstruction is usually performed in conjunction with insertion of acellular dermal matrix (ADM). However, the effects of ADM use on TE loss or other early complications remain unknown. Therefore, the aim of this study was to compare early postoperative complications in patients who underwent prepectoral breast implant reconstruction with or without ADM use. Methods: The authors performed a retrospective cohort study of all patients at their institution who underwent prepectoral breast reconstruction from January of 2018 to June of 2021. The primary outcome was TE loss within 90 days of surgery; secondary outcomes included other complications such as infection, TE exposure, mastectomy skin flap necrosis requiring revision, and seroma. Results: Data on 714 patients with 1225 TEs (1060 with ADM and 165 without) were analyzed. Baseline demographics did not differ by ADM use, although mastectomy breast tissue weight was higher in patients without ADM (750.3 g versus 540.8 g; P < 0.001). Rates of TE loss were similar in reconstructions with (3.8%) ADM and without (6.7%; P = 0.09). We also did not find differences in the rates of secondary outcomes between cohorts. Conclusions: ADM use had no statistically significant effect on early complication rates among patients undergoing breast reconstruction with prepectoral TEs. Still, this study was underpowered, and data trended toward statistical significance; thus, larger studies are required in the future. Additional research and randomized studies should focus on larger cohorts and examine long-term complications such as capsular contracture and implant malposition.
Keywords: tissue expander; implant reconstruction
Journal Title: Plastic and Reconstructive Surgery
Volume: 153
Issue: 4
ISSN: 0032-1052
Publisher: Lippincott Williams & Wilkins  
Date Published: 2024-04-01
Start Page: 786
End Page: 793
Language: English
ACCESSION: WOS:001289041800045
DOI: 10.1097/prs.0000000000010712
PROVIDER: wos
PUBMED: 37220401
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding authors are Joseph Disa and Jonas Nelson -- Source: Wos
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MSK Authors
  1. Joseph Disa
    265 Disa
  2. Babak Mehrara
    454 Mehrara
  3. Evan Matros
    207 Matros
  4. Joseph Henry Dayan
    101 Dayan
  5. Robert J Allen Jr
    101 Allen Jr
  6. Jonas Allan Nelson
    217 Nelson
  7. Michelle Renee Coriddi
    63 Coriddi
  8. Kathryn Ann Haglich
    27 Haglich