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Tissue 'lattice' effective in breast reconstruction

Article-Tissue 'lattice' effective in breast reconstruction

New York — Acellular dermal matrices (ADMs) provide good outcomes, with low complication rates, when used for breast reconstruction after mastectomy for breast cancer.

The study, published in the June issue of the American Society of Plastic Surgeons’ Plastic and Reconstructive Surgery, describes the use of two types of ADM materials in the initial stage of breast reconstruction — specifically, for supporting the underside of the breast.

According to an ASPS news release, surgeons say that with careful attention to technical details, ADMs can provide consistently good results in breast reconstruction.

Study investigators described their experience with ADMs in 186 women undergoing two-stage breast reconstruction after mastectomy for breast- cancer treatment or prevention between 2004 and 2007. The surgeons reconstructed a total of 270 breasts using ADMs. Initially they used ADMs created from donated human skin (AlloDerm), and then later used a product made from porcine skin (Strattice). They analyzed the results and complications of the ADM reconstructions.

The surgeons found the overall complication rate to be higher with AlloDerm than with Strattice (about 21 versus 6 percent), likely a reflection of the higher rate of seromas with AlloDerm, according to an ASPS news release. Other complications were similar between groups, with no difference in serious complications.

With both types of ADM, there was a 2 percent rate of mild capsular contracture-hardening of the tissues around the implant, compared with a 10 to 20 percent rate for reconstructions that did not use ADMs. Follow-up evaluations showed good final results with both types of ADMs.

The good outcomes, coupled with low risk of serious complications, “justifies the cost associated with the use of ADMs in breast reconstruction,” the researchers wrote.

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