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Tissue Expander Breast Reconstruction Using Prehydrated Human Acellular Dermis

2011; Lippincott Williams & Wilkins; Volume: 66; Issue: 6 Linguagem: Inglês

10.1097/sap.0b013e3181f3ed0a

1536-3708

Vinay Rawlani, Donald W. Buck, Sarah A. Johnson, Kamaldeep Heyer, John Y. S. Kim,

Reconstructive Facial Surgery Techniques

Introduction: Human acellular dermal matrices help facilitate immediate tissue expander-implant breast reconstruction by providing support to the inferolateral pole, improving control of implant position, and enhancing early volume expansion. Although several freeze-dried human acellular dermal products have demonstrated reasonable safety and efficacy in immediate tissue expander-implant breast reconstruction, no dedicated studies have evaluated clinical outcomes of prehydrated human acellular dermal matrix (PHADM) in breast reconstruction. Methods: The outcomes of 121 consecutive tissue expander reconstructions performed by the senior author using PHADM were evaluated. Results: Mean intraoperative tissue expander fill volume was 256.6 ± 133 mL, 60% of final expander volume. Patients required an average of 3.2 additional expansions prior to tissue expander-to-implant exchange. Mean follow-up period after reconstruction was 44 ± 26.5 weeks. Complications occurred in 20 (16.5%) breasts, including 9 (7.4%) soft-tissue infections, 8 (6.6%) partial mastectomy flap necroses, and 2 (1.7%) seromas. Eleven (9.1%) breasts ultimately required explantation. Patients receiving radiation demonstrated a strong trend toward greater complications (30.8% vs. 13.7%, P = 0.0749). Conclusions: The outcomes and complication rates of PHADM tissue expander breast reconstruction are comparable to those reported with freeze-dried human acellular dermis.