TY - JOUR
T1 - The effect of acellular dermal matrix on drain secretions after immediate prosthetic breast reconstruction
AU - Israeli Ben-Noon, Hadar
AU - Farber, Nimrod
AU - Weissman, Oren
AU - Tessone, Ariel
AU - Stavrou, Demetris
AU - Shabtai, Moshe
AU - Maor, Yasmin
AU - Haik, Joseph
AU - Winkler, Eyal
PY - 2013/9
Y1 - 2013/9
N2 - In recent years the acellular dermal matrix (ADM) has gained popularity in prosthetic breast reconstruction. These procedures involve placement of a closed suction drain in the reconstructed breast. Although it is now widely accepted that ADM has an overall positive effect on the outcome of breast reconstruction, data regarding its effect on postoperative drain secretions is lacking. This study was designed to quantitatively evaluate the influence of ADM on postoperative drain secretions in the setting of immediate prosthetic breast reconstruction (IPBR). This is a prospective, comparative controlled study. Two groups of 16 patients each underwent skin sparing mastectomies (SSM) and IPBR with or without ADM. Closed suction drains were left in all the reconstructed breasts and daily secretion volumes were recorded and compared. Postoperative complications were also noted. Patients in the ADM group showed higher daily and overall secretion volumes compared with patients in the control group (p = 0.014) and the time for removal of the drains was higher by an average of 5 days (13 compared with 8 days, respectively; p = 0.004). There was no correlation between ADM and infection. This study provides the first objective evidence that ADM contributes to elevated and prolonged drain secretions when used for IPBR. This might affect possible prosthesis-related complications (e.g., rotation and malposition, capsular contraction, seroma formation, and infection). This study also noted erythema of the post-mastectomy skin flaps in selected patients, which may be attributable to a local inflammatory reaction to the ADM rather than infection.
AB - In recent years the acellular dermal matrix (ADM) has gained popularity in prosthetic breast reconstruction. These procedures involve placement of a closed suction drain in the reconstructed breast. Although it is now widely accepted that ADM has an overall positive effect on the outcome of breast reconstruction, data regarding its effect on postoperative drain secretions is lacking. This study was designed to quantitatively evaluate the influence of ADM on postoperative drain secretions in the setting of immediate prosthetic breast reconstruction (IPBR). This is a prospective, comparative controlled study. Two groups of 16 patients each underwent skin sparing mastectomies (SSM) and IPBR with or without ADM. Closed suction drains were left in all the reconstructed breasts and daily secretion volumes were recorded and compared. Postoperative complications were also noted. Patients in the ADM group showed higher daily and overall secretion volumes compared with patients in the control group (p = 0.014) and the time for removal of the drains was higher by an average of 5 days (13 compared with 8 days, respectively; p = 0.004). There was no correlation between ADM and infection. This study provides the first objective evidence that ADM contributes to elevated and prolonged drain secretions when used for IPBR. This might affect possible prosthesis-related complications (e.g., rotation and malposition, capsular contraction, seroma formation, and infection). This study also noted erythema of the post-mastectomy skin flaps in selected patients, which may be attributable to a local inflammatory reaction to the ADM rather than infection.
KW - ADM (acellular dermal matrix)
KW - Alloderm
KW - Breast
KW - Breast drain
KW - Breast implants
KW - Breast reconstruction
KW - Drain's secretions
UR - http://www.scopus.com/inward/record.url?scp=84882793607&partnerID=8YFLogxK
U2 - 10.3109/2000656X.2013.766202
DO - 10.3109/2000656X.2013.766202
M3 - Article
C2 - 23710783
AN - SCOPUS:84882793607
SN - 2000-656X
VL - 47
SP - 308
EP - 312
JO - Journal of Plastic Surgery and Hand Surgery
JF - Journal of Plastic Surgery and Hand Surgery
IS - 4
ER -