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CC BY-NC 4.0 · Arch Plast Surg 2019; 46(03): 204-213
DOI: 10.5999/aps.2018.01137
Original Article

A comparative study between sterile freeze-dried and sterile pre-hydrated acellular dermal matrix in tissue expander/implant breast reconstruction

Jeong Hyun Cheon 
Department of Plastic and Reconstructive Surgery, Korea University College Medicine, Seoul, Korea
,
Eul Sik Yoon 
Department of Plastic and Reconstructive Surgery, Korea University College Medicine, Seoul, Korea
,
Jin Woo Kim 
Department of Plastic and Reconstructive Surgery, Korea University College Medicine, Seoul, Korea
,
Seung Ha Park 
Department of Plastic and Reconstructive Surgery, Korea University College Medicine, Seoul, Korea
,
Byung Il Lee 
Department of Plastic and Reconstructive Surgery, Korea University College Medicine, Seoul, Korea
› Author AffiliationsThis article was presented at the PRS Korea 2017 on November 10–12, 2017, in Seoul, Korea.
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Background In implant-based breast reconstruction, acellular dermal matrix (ADM) is essential for supporting the inferolateral pole. Recent studies have compared non-sterilized freeze-dried ADM and sterilized pre-hydrated ADM, but have not assessed whether differences were attributable to factors related to sterile processing or packaging. This study was conducted to compare the clinical outcomes of breast reconstruction using two types of sterile-processed ADMs.

Methods Through a retrospective chart review, we analyzed 77 consecutive patients (85 breasts) who underwent tissue expander/implant breast reconstruction with either freeze-dried ADM (35 breasts) or pre-hydrated ADM (50 breasts) from March 2016 to February 2018. Demographic variables, postoperative outcomes, and operative parameters were compared between freeze-dried and pre-hydrated ADM. Biopsy specimens were obtained for histologic analysis.

Results We obtained results after adjusting for variables found to be significant in univariate analyses. The total complication rate for freeze-dried and pre-hydrated ADMs was 25.7% and 22.0%, respectively. Skin necrosis was significantly more frequent in the freeze-dried group than in the pre-hydrated group (8.6% vs. 4.0%, P=0.038). All other complications and operative parameters showed no significant differences. In the histologic analysis, collagen density, inflammation, and vascularity were higher in the pre-hydrated ADM group (P=0.042, P=0.006, P=0.005, respectively).

Conclusions There are limited data comparing the outcomes of tissue expander/implant breast reconstruction using two types of sterile-processed ADMs. In this study, we found that using pre-hydrated ADM resulted in less skin necrosis and better integration into host tissue. Pre-hydrated ADM may therefore be preferable to freeze-dried ADM in terms of convenience and safety.

Keywords

Breast implants - Acellular dermis - Mammaplasty - Sterilization


Publication History

Received: 17 September 2018

Accepted: 06 March 2019

Article published online:
28 March 2022

© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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