期刊
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN
卷 10, 期 4, 页码 -出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GOX.0000000000004258
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资金
- Allergan Aesthetics, an AbbVie company, Irvine, California
This study compared complications in breast reconstruction patients using acellular dermal matrix (ADM) versus those not using ADM over a 5-year period. The results showed that patients using ADM had lower rates of capsular contracture and seroma, and the procedure was more successful overall.
Background: Few studies have assessed long-term complications in women undergoing implant-based breast reconstruction with use of an acellular dermal matrix(ADM). This study compared outcomes over 5 years in women undergoing breast reconstruction procedures with and without ADM. Methods: Complications data in patients enrolled in the prospective Continued Access Reconstruction/Revision Expansion trial were segregated by use of ADM versus no ADM in patients undergoing primary breast reconstruction or revision reconstruction.Continued Access Reconstruction/Revision Expansion trial evaluated long-term safety and effectiveness of shaped, textured, silicone implants. Results: Of the 9502 women, 257 had primary (n = 160) or revision-reconstruction(n = 97) with ADMs; 9245 had primary (n = 6977) or revision-reconstruction (n = 2268)without ADMs. Capsular contracture rates in primary reconstruction were lower with ADM than without at year 5 (3.2% versus 7.4%); rates were similar at year 1 (=2.4%). Capsular contracture rates in revision-reconstruction were lower with ADM than without at year 5 (1.4% versus 8.9%); rates were similar at year 1 (=2.5%). Seroma rates were low and sustained for all cohorts throughout the 5 years (=2.9%). Reoperation rates increased over time in all cohorts, with similar rates between groups (2.4%47.3%from week 4 to year 5 across cohorts). Other trends over time included lower rates for asymmetry and implant malposition with ADM than without. Conclusion: These long-term data suggest that the use of ADM in breast reconstruction procedures may provide a benefit in reducing complications, such as capsular contracture, and may sustain low rates of seroma.
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