Human acellular dermis versus no acellular dermis in tissue expansion breast reconstruction

Joseph W. Parks, Sarah E. Hammond, William A. Walsh, Robert L. Adams, Robert G. Chandler, Edward Luce

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

BACKGROUND: Human acellular dermis has been adopted for routine use in tissue expander reconstruction. The purported benefits include higher intraoperative fill volume, facilitation of lower pole expansion, and enhanced definition of the lower pole of the breast. Recently, concerns have arisen about an increase in postoperative complications with its use. METHODS: A retrospective review was conducted of patients who had immediate postmastectomy breast reconstruction with a tissue expander from July of 2001 to July of 2011. All tissue expander reconstructions before 2005 were performed submuscularly only and all subsequent to 2005 with the use of AlloDerm (LifeCell, Branchburg, N.J.) acellular dermis. Patient demographics were collected, and complications were recorded. RESULTS: The study cohort included 346 patients and 511 immediate breast reconstructions; 232 patients and 346 breasts were reconstructed with and 114 patients and 165 breasts without acellular dermis. Age, body mass index, diabetes, and tobacco use were equivalent in the two groups. Seroma occurrence in the acellular dermis group was nearly twice (30.0 versus 15.1 percent) that of the no acellular dermis breasts, but the tissue expander loss was only slightly higher (11.6 versus 8.5 percent) and not statistically significant. Body mass index in patients who lost their tissue expander was 31 kg/m, statistically significantly higher than in those who did not. CONCLUSIONS: The presence of acellular dermis did not increase the incidence of tissue expander loss, despite a doubling of frequency of seroma. Prior radiation and use of acellular dermis did culminate in a prohibitively high loss rate of the tissue expander. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Original languageEnglish (US)
Pages (from-to)739-746
Number of pages8
JournalPlastic and Reconstructive Surgery
Volume130
Issue number4
DOIs
StatePublished - Oct 1 2012

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Acellular Dermis
Tissue Expansion Devices
Tissue Expansion
Mammaplasty
Breast
Seroma
Body Mass Index
Tobacco Use
Cohort Studies
Demography
Radiation
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Human acellular dermis versus no acellular dermis in tissue expansion breast reconstruction. / Parks, Joseph W.; Hammond, Sarah E.; Walsh, William A.; Adams, Robert L.; Chandler, Robert G.; Luce, Edward.

In: Plastic and Reconstructive Surgery, Vol. 130, No. 4, 01.10.2012, p. 739-746.

Research output: Contribution to journalArticle

Parks, Joseph W. ; Hammond, Sarah E. ; Walsh, William A. ; Adams, Robert L. ; Chandler, Robert G. ; Luce, Edward. / Human acellular dermis versus no acellular dermis in tissue expansion breast reconstruction. In: Plastic and Reconstructive Surgery. 2012 ; Vol. 130, No. 4. pp. 739-746.
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