Early complications and implant loss in implant-based breast reconstruction with and without acellular dermal matrix (Tecnoss Protexa®): A comparative study. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Potter, S.; Chambers, A.; Govindajulu, S.; Sahu, A.; Warr, R.; Cawthorn, S.
• Is Part Of: European journal of surgical oncology. Volume 41:Issue 1(2015:Jan.)
• Page Start: 113
• Page End: 119
• Publication Date: 2015-01
• Subjects: Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2013.08.016
• Languages: English
• ISSNs: 0748-7983

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Introduction</title> <p id="abspara0010">Acellular dermal matrix (ADM) may improve outcomes in implant-based breast reconstruction, but recent evidence suggests complication rates may be higher when ADM is used. We retrospectively compared early complications and implant loss in implant-based breast reconstruction (BR) with and without ADM to evaluate the safety of the procedure in our centre.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Case-notes of consecutive women undergoing implant-based BR from May 2011 to November 2012 were retrospectively reviewed. Data were extracted using a standardised pro-forma and the rate of early complications, major complications and implant loss compared between procedure groups.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Forty-six implant-based reconstructions were performed for malignancy (<italic>n</italic> = 31, 67.4%) or prophylaxis (<italic>n</italic> = 15, 32.6%) in 31 women over the 18-month study period. ADM (Tecnoss Protexa<sup>®</sup>, Tecnoss S.r.l.) was used in 31 (67.4%) cases. There were no differences in patient age, BMI, co-morbidities, smoking or chemotherapy between groups, but patients receiving ADM were more likely to have received radiotherapy prior to their reconstruction (<italic>n</italic> = 6, 30% vs. <italic>n</italic> = 0, 0%, <italic>p</italic> = 0.043).</p> <p id="abspara0025">The overall rate of early complications was 26.1% (<italic>n</italic> = 12) but there was no significant difference between procedure groups (standard-<italic>n</italic> = 4, 27.7% vs. ADM-<italic>n</italic> = 8, 25.8%; <italic>p</italic> = 0.950). There were 2 (4.3%) major complications none of which were associated with ADM use (standard-<italic>n</italic> = 2, 13.3% vs. ADM-<italic>n</italic> = 0, 0.0%; <italic>p</italic> = 0.038). There were 6 (13.0%) implant losses of which 4 were in the ADM group (standard-<italic>n</italic> = 2, 13.3% vs. ADM-<italic>n</italic> = 4, 12.9%; <italic>p</italic> = 0.968). All of these were associated with pre-reconstruction radiotherapy.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0030">ADM-assisted implant-based reconstruction with Tecnoss Protexa<sup>®</sup> is safe and may improve outcomes for women by facilitating a single-stage procedure. Robust prospective evaluation is now needed to definitively evaluate the role of ADM in implant-based BR.</p> </sec> </abstract>