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Complication rates differ in types of acellular dermal matrices
Patients who underwent immediate implant-based breast reconstruction with FlexHD acellular dermal matrices were more likely to develop infection and other complications when compared with other acellular dermal matrices, including AlloDerm, according to study results.
In research presented at the joint meeting of the American Association of Plastic Surgeons and the Plastic Surgery Research Council, researchers compared complications from immediate breast reconstructions in 810 patients from 11 sites. There were 507 patients reconstructed with AlloDerm (LifeCell), 128 patients with FlexHD (Ethicon) and 175 patients with another type of material, including AlloMax (Bard Davol), SERI Scaffold (Allergan), Biodesign (Cook Medical), SurgiMend (TEI Biosciences) or Vicryl (Ethicon).
The researchers used hierarchical logistic regression models to analyze complications including hematoma, seroma, mastectomy flap necrosis, wound infection, wound dehiscence and reconstructive failure, accounting for demographic and clinical variables.
Patients who had immediate breast reconstruction using FlexHD were significantly more likely to experience an infection (OR = 2.79; 95% CI, 1.07-7.26), reconstructive failure (OR = 3.3; 95% CI, 1.4-7.56), or any complication (OR = 2.8; 95% CI, 1.63-4.8) when compared with patients in the AlloDerm cohort.
“Patients undergoing immediate implant-based breast reconstruction with FlexHD had significantly increased odds of developing infection, reconstructive failure and any other sort of complication compared to those with AlloDerm,” the researchers concluded. – by Bruce Thiel
Reference:
Santosa KB, et al. Are all acellular dermal matrices (ADMs) created equal? Results from a multicenter prospective study. Presented at: Joint meeting of American Association of Plastic Surgeons and the Plastic Surgery Research Council; May 19-22, 2016; New York.
Disclosure: Healio.com/Aesthetics could not determine relative financial disclosures at time of publication.
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This study demonstrates that the type of ADM used does matter when it comes to overall complications, implant failure and major infections, and that they’re not all the same, which certainly impacts clinical practice.
This study is unique compared to previous data from smaller studies comparing complication rates in ADMs used in immediate breast reconstruction in that it was a large, independent, prospective, multicenter clinical trial. It’s the first time we’ve seen data from such a large patient population that controls for site and surgeon differences.