Abstract
Background Acellular matrices (AM) might enable a direct single-stage breast reconstruction procedure resulting in an improved efficacy of the reconstruction phase for patients. Safety concerns are an important issue due to a recent study which shows that single-stage breast reconstruction with Strattice T resulted in more complications versus a two-stage reconstruction. Therefore, the goal of this study is to compare the short-and long-term complications of a single-stage breast reconstruction with the use of two types of AM (Strattice T and Meso Biomatrix (R)) versus two-stage breast reconstruction without the use of an AM. Methods Cohort study with single-stage breast reconstruction with Strattice T (n = 28) or Meso BioMatrix (R) (n = 20) or twostage breast reconstruction without an AM (n = 36) at the Maastricht Academic Hospital, the Netherlands. All complications, in particular major complications with the need for re-admission to the hospital, re-exploration, and implant explantation, were the primary outcome measures. A 1-year follow-up was achieved for all patients. Results Baseline characteristics of all 52 patients were similar between groups. There was a significantly higher complication rate in the single-stageAM groups with loss of the implant in 40.0% of the breasts from the Meso BioMatrix (R) group and in 10.7% of the Strattice T group compared to no implant loss in the control group. Conclusions This cohort study clearly suggests that the use of a single-stage breast reconstruction is not safe with the use of these AMs. Well-designed prospective studies that guarantee the safety of those matrices should be published before these AMs are used in implant-based surgery. Level of Evidence: Level III, risk /prognostic study.
Original language | English |
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Pages (from-to) | 429-438 |
Number of pages | 10 |
Journal | European Journal of Plastic Surgery |
Volume | 41 |
Issue number | 4 |
DOIs | |
Publication status | Published - 1 Aug 2018 |
Keywords
- Acellular dermis
- Breast implant
- Breast reconstruction
- Mesh matrix
- Implant-based
- Postoperative complications
- DERMAL MATRIX
- TISSUE EXPANDER
- RISK-FACTORS
- COMPLICATIONS
- OUTCOMES
- METAANALYSIS
- IMPACT
- MASTECTOMY
- EXPANSION
- SURGERY