Successful breast reconstruction using acellular dermal matrix can be recommended in healthy non-smoking patients

Dan Med J. 2013 Dec;60(12):A4751.

Abstract

Introduction: We present Scandinavia's first series of immediate alloplastic breast reconstructions with an acellular dermal matrix.

Material and methods: Data were collected retrospectively in 76 cases of immediate breast reconstruction using an acellular dermal matrix (ADM) and an implant.

Results: A total of 59 women were reconstructed between June 2011 and January 2013. Cases included 42 unilateral and 17 bilateral reconstructions. A large number of patients had adjuvant therapy, hormone therapy (34), radiation therapy (27) or chemotherapy (38). The median age was 51 years (30-70 years) and the median follow-up period was 326 days (68-624 days). The co-morbidity factors included hypertension (n = 11), diabetes (n = 2) and 19 patients were smokers. Unsuccessful reconstructions counted ten cases (13%), eight of these due to necrosis and/or wound dehiscence (10%) and two due to infection (3%). The failure rate in non-smokers was 2/52 (4%) compared with 8/24 (33%) in smokers, p = 0.001. In hypertensive patients, the failure rate was 6/12 (50%) compared with 4/64 (6%)in normotensive patients, p = 0.001. 70% of the failed reconstructions occurred in patients older than 65 years of age.

Conclusion: Immediate alloplastic breast reconstruction using an ADM can be recommended to healthy non-smoking patients.

Funding: not relevant.

Trial registration: not relevant.

MeSH terms

  • Acellular Dermis*
  • Adult
  • Age Factors
  • Aged
  • Breast Neoplasms / complications
  • Breast Neoplasms / therapy*
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Hypertension / complications*
  • Mammaplasty / adverse effects
  • Mammaplasty / methods*
  • Mastectomy, Segmental
  • Middle Aged
  • Necrosis / etiology
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Smoking / adverse effects*
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Infection / etiology
  • Time Factors
  • Treatment Failure
  • Treatment Outcome