Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction

Purpose. The acellular dermal matrix plays an important role in reinforcing thin mastectomy skin and repositioning the implant in prosthetic breast reconstruction. As the concept of prepectoral plane has become widespread, the role of the acellular dermal matrix has become increasingly important. Ho...

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Autores principales:	Joon Hur, Hyun Ho Han
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/b00fa02f27ab449fb97b4a3e5d99feac
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spelling	oai:doaj.org-article:b00fa02f27ab449fb97b4a3e5d99feac2021-11-29T00:55:43ZOutcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction2314-614110.1155/2021/8101009https://doaj.org/article/b00fa02f27ab449fb97b4a3e5d99feac2021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/8101009https://doaj.org/toc/2314-6141Purpose. The acellular dermal matrix plays an important role in reinforcing thin mastectomy skin and repositioning the implant in prosthetic breast reconstruction. As the concept of prepectoral plane has become widespread, the role of the acellular dermal matrix has become increasingly important. However, evidences and standards for appropriate thickness and direction during placement remain insufficient. This study is aimed at testing the assumption that differences in the acellular dermal matrix thickness and orientation during placement may affect surgical outcomes including the incidence of postoperative complications. Methods. This was a retrospective single-centered analysis of 43 patients (50 breasts) who underwent implant-based reconstruction with MegaDerm® (L&C Bio, Seoul, Korea) and 23 patients (23 breasts) who underwent implant-based reconstruction with DermACELL® (LifeNet Health, Virginia Beach, VA, USA), two types of human-derived acellular dermal matrix. All surgeries were performed by a single surgeon. Demographic variables, surgery-related factors, and complications were compared between a thick matrix group (1.5–2.3 mm) and a thin matrix group (1.0–1.5 mm). The same processes were performed in the nonreverse and reverse matrix insertion groups. Results. Baseline demographics and surgery-related data were summarized according to matrix thickness and direction. There were no significant intergroup differences in the demographic variables such as history of smoking, radiation, or chemotherapy. The mean drain volume was significantly higher in the thick matrix group than that in the thin matrix group (p=0.0445). However, there were no significant differences in overall complication rates by matrix thickness (p=0.3139). Additionally, there were no significant differences in complications between the nonreverse and reverse matrix insertion groups (p=0.538). Conclusion. Our findings suggest that patients with a thick acellular dermal matrix need a prolonged period for engraftment. However, the thickness did not directly affect the surgical outcomes between the thick and thin matrix groups. Likewise, the orientation in which the acellular dermal matrix was inserted did not affect the surgical outcomes including postoperative complications.Joon HurHyun Ho HanHindawi LimitedarticleMedicineRENBioMed Research International, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Joon Hur Hyun Ho Han Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction
description	Purpose. The acellular dermal matrix plays an important role in reinforcing thin mastectomy skin and repositioning the implant in prosthetic breast reconstruction. As the concept of prepectoral plane has become widespread, the role of the acellular dermal matrix has become increasingly important. However, evidences and standards for appropriate thickness and direction during placement remain insufficient. This study is aimed at testing the assumption that differences in the acellular dermal matrix thickness and orientation during placement may affect surgical outcomes including the incidence of postoperative complications. Methods. This was a retrospective single-centered analysis of 43 patients (50 breasts) who underwent implant-based reconstruction with MegaDerm® (L&C Bio, Seoul, Korea) and 23 patients (23 breasts) who underwent implant-based reconstruction with DermACELL® (LifeNet Health, Virginia Beach, VA, USA), two types of human-derived acellular dermal matrix. All surgeries were performed by a single surgeon. Demographic variables, surgery-related factors, and complications were compared between a thick matrix group (1.5–2.3 mm) and a thin matrix group (1.0–1.5 mm). The same processes were performed in the nonreverse and reverse matrix insertion groups. Results. Baseline demographics and surgery-related data were summarized according to matrix thickness and direction. There were no significant intergroup differences in the demographic variables such as history of smoking, radiation, or chemotherapy. The mean drain volume was significantly higher in the thick matrix group than that in the thin matrix group (p=0.0445). However, there were no significant differences in overall complication rates by matrix thickness (p=0.3139). Additionally, there were no significant differences in complications between the nonreverse and reverse matrix insertion groups (p=0.538). Conclusion. Our findings suggest that patients with a thick acellular dermal matrix need a prolonged period for engraftment. However, the thickness did not directly affect the surgical outcomes between the thick and thin matrix groups. Likewise, the orientation in which the acellular dermal matrix was inserted did not affect the surgical outcomes including postoperative complications.
format	article
author	Joon Hur Hyun Ho Han
author_facet	Joon Hur Hyun Ho Han
author_sort	Joon Hur
title	Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction
title_short	Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction
title_full	Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction
title_fullStr	Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction
title_full_unstemmed	Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction
title_sort	outcome assessment according to the thickness and direction of the acellular dermal matrix after implant-based breast reconstruction
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/b00fa02f27ab449fb97b4a3e5d99feac
work_keys_str_mv	AT joonhur outcomeassessmentaccordingtothethicknessanddirectionoftheacellulardermalmatrixafterimplantbasedbreastreconstruction AT hyunhohan outcomeassessmentaccordingtothethicknessanddirectionoftheacellulardermalmatrixafterimplantbasedbreastreconstruction
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Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction

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