Use of 801 Acellular Dermal Matrices (ADMs) in Direct-to-Implant Breast Reconstruction: A Clinical Observation of Complication Profiles Over a 7-Year Period

Haim Yoel Kaplan; Roman Rysin

doi:10.1093/asj/sjae238

Use of 801 Acellular Dermal Matrices (ADMs) in Direct-to-Implant Breast Reconstruction: A Clinical Observation of Complication Profiles Over a 7-Year Period

Aesthet Surg J. 2024 Dec 11:sjae238. doi: 10.1093/asj/sjae238. Online ahead of print.

Authors

Haim Yoel Kaplan¹, Roman Rysin²

Affiliations

¹ Department of Plastic Surgery, Yitzhak Shamir Medical Center, Tzrifin, Israel.
² Private practice, Tel Aviv, Israel.

PMID: 39661417
DOI: 10.1093/asj/sjae238

Abstract

Background: The emergence of acellular dermal matrices (ADMs) revolutionized pre-pectoral breast reconstruction, allowing partial or complete implant coverage. ADM had been described to possess several important benefits, nevertheless literature described increased postoperative complication rate.

Objectives: Delineate the senior author experience with ADM (DermaCell; Stryker, Kalamazoo, MI) in direct-to-implant (DTI) breast reconstruction. Describe complication rate and patient's satisfaction.

Methods: This is a retrospective patients cohort, undergoing primary or revisionary breast reconstruction (DTI), utilizing DermaCell, from Jan 2017 to Jan 2024.

Results: 230 consecutive patients, 410 breasts, 801 DermaCell sheets were evaluated. All were DTI breast reconstructions. Complication rate were described per breast. Total of 92 cases of complication occurred (22.4%). Rippling was seen in eighteen breasts (4.39%), skin ischemia in twenty-one breast (5.12%), hematoma in five (1.21%), seroma in nine (2.19%). 17 breasts experienced capsular contraction. In the non-irradiated group, capsular contracture (CC), baker grade 3-4, was seen in four breasts (1.11%) and nine (18%) in the irradiated group. Postoperative follow up period was 18 months (range: 6-84 months).BREAST-Q: satisfaction with breast increased by a mean of 10.45. Satisfaction with the implant was 6.61 out of 8.

Discussion: This cohort represents the most comprehensive and up-to-date experience with DermaCell (ADM) for direct-to-implant (DTI) breast reconstructive surgery. The favorable complication profile suggests that ADM offers a safe and reliable option, making it an important tool in the armamentarium of the reconstructive plastic surgeon.

Conclusions: DermaCell is an important component in pre-pectoral breast reconstruction, contributing to better results, improved complication profile and patient's satisfaction.

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