The use of acellular dermal matrices in two-stage expander/implant reconstruction: a multicenter, blinded, randomized controlled trial Journal Article
| Authors: | McCarthy, C. M.; Lee, C. N.; Halvorson, E. G.; Riedel, E.; Pusic, A. L.; Mehrara, B. J.; Disa, J. J. |
| Article Title: | The use of acellular dermal matrices in two-stage expander/implant reconstruction: a multicenter, blinded, randomized controlled trial |
| Abstract: | Current efficacy data supporting the routine use of acellular dermal matrices in postmastectomy tissue expander/implant reconstruction are limited. A multicenter, blinded, randomized controlled study was designed to evaluate the effectiveness of acellular dermal matrix in the setting of tissue expander/implant reconstruction. The primary objective of the study was to determine whether the use of matrix would decrease patient-reported postoperative pain. The secondary objective was to determine whether its use would accelerate the rate of postoperative expansion. The randomized controlled trial was conducted at two U.S. centers from 2008 to 2011. Immediately following mastectomy, all patients were randomized to one of two treatment arms: (1) acellular dermal matrix-assisted, tissue expander/implant reconstruction; and (2) submuscular tissue expander/implant placement. All patients were blinded to their treatment arm. One hundred eight consented to participate; 38 were excluded prior to randomization. In total, 70 patients were randomized. There were no differences seen in immediate postoperative pain (p = 0.19) or pain during the expansion phase (p = 0.65) between treatment arms. There was similarly no difference in postoperative narcotic use (p = 0.38). The rate of postoperative expansion did not differ between groups (p = 0.83). The results suggest that the use of acellular dermal matrix in the setting of tissue expander/implant reconstruction neither reduces postoperative pain nor accelerates the rate of postoperative expansion. An examination of its efficacy in improving long-term outcomes following tissue expander/implant reconstruction is warranted. |
| Keywords: | adult; controlled study; treatment outcome; aged; middle aged; patient satisfaction; multimodality cancer therapy; antineoplastic agents; comparative study; chemotherapy, adjuvant; combined modality therapy; methodology; antineoplastic agent; quality of life; controlled clinical trial; mastectomy; randomized controlled trial; breast neoplasms; breast reconstruction; mammaplasty; tissue expansion devices; time; time factors; psychological aspect; multicenter study; adjuvant chemotherapy; breast tumor; collagen; esthetics; pain measurement; pain assessment; patient controlled analgesia; postoperative pain; analgesia, patient-controlled; pain, postoperative; breast augmentation; narcotic agent; single blind procedure; tissue expander; breast implantation; single-blind method; alloderm; acellular dermal matrix; narcotics; acellular dermis; implant capsular contracture |
| Journal Title: | Plastic and Reconstructive Surgery |
| Volume: | 130 |
| Issue: | 5 Suppl 2 |
| ISSN: | 0032-1052 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2012-11-01 |
| Start Page: | 57S |
| End Page: | 66S |
| Language: | English |
| PUBMED: | 23096987 |
| PROVIDER: | scopus |
| PMCID: | PMC4100590 |
| DOI: | 10.1097/PRS.0b013e31825f05b4 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 March 2013" - "Source: Scopus" |
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203Stubblefield -
262Disa -
300Pusic -
448Mehrara -
143McCarthy
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