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Author Notes:

Orion Paul Keifer, Jr, MD, PhD, Emory University School of Medicine, c/o Emory MD/PhD Program, 1648 Pierce Dr NE, Atlanta, GA 30307, E-mail: okeifer@emory.edu

We thank Drs. Shannon Gourley and Robert Lyles for sharing their time and expertise with advanced statistical analysis.

Dr. Losken is a speaker for RTI, LifeCell, and Novadaq. Neither of the other authors has any financial disclosures. The Article Processing Charge was paid for by RTI Surgical, Inc.

Subject:

A Complication Analysis of 2 Acellular Dermal Matrices in Prosthetic-based Breast Reconstruction.

Tools:

Journal Title:

Plastic and Reconstructive Surgery, Global Open

Volume:

Volume 4, Number 7

Publisher:

, Pages e800-e800

Type of Work:

Article | Final Publisher PDF

Abstract:

BACKGROUND: Acellular dermal matrices (ADM) are now routine in postmastectomy prosthetic-based breast reconstruction. The goal of the current study was to compare the complications of 2 ADM products-AlloDerm and Cortiva. METHODS: A retrospective analysis of prosthetic-based breast reconstruction in Atlanta, Ga., over 5 years. Inclusion criteria were the use of the ADM types (AlloDerm or Cortiva) and use of a tissue expander or implant. Statistical analysis compared group demographics, risk factors, and early complications. RESULTS: Of the 298 breast reconstructions, 174 (58.4%) used AlloDerm and 124 (41.6%) used Cortiva. There was no difference in overall complication frequency (16 AlloDerm and 18 Cortiva; P = 0.195). Within specific categories, there was a difference in mastectomy skin flap necrosis, but, based on further regression analysis, this was attributable to differences in body mass index (P = 0.036). Furthermore, there were no differences in the rates of infection (6 AlloDerm and 5 Cortiva; P = 1.0), seroma/hematoma (9 AlloDerm and 7 Cortiva; P = 1.0), or drain duration (13.2 day AlloDerm and 14.2 day Cortiva, P = 0.2). By using a general estimating equation for binomial logistical regression, it was found that only current tobacco use (P = 0.033) was a significant predictor for a complication. Trending predictors were body mass index (P = 0.074) and age (P = 0.093). The type of matrix was not a significant predictor for any of the recorded complication (P = 0.160). CONCLUSIONS: Although AlloDerm is well established, we have shown that Cortiva has an equivalent complication frequency. Future work will focus on long-term outcome measures and histological evaluation of vascularization and integration.

Copyright information:

© 2016 The Authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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