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KMID : 1038220220490020166
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Archives of Plastic Surgery
2022 Volume.49 No. 2 p.166 ~ p.173
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Meshed Acellular Dermal Matrix for Two-Staged Prepectoral Breast Reconstruction: An Institutional Experience
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Luo Jessica
Willis Rhett N. Jr.
Ohlsen Suzanna M.
Piccinin Meghan
Moores Neal
Kwok Alvin C.
Agarwal Jayant P.
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Abstract
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The introduction of acellular dermal matrix (ADM) to breast reconstruction has allowed surgeons to reexplore the prepectoral implant placement technique in postmastectomy breast reconstruction. Our institution adopted a novel approach using meshed ADM to lessen the financial burden of increased ADM utilization with the prepectoral breast reconstruction. This is a retrospective, single-center review of two-stage prepectoral breast reconstruction using meshed human-derived ADM for anterior prosthesis coverage. Patient demographics, oncologic data, perioperative characteristics, and complications were examined and reported as means with standard deviations. Cost-saving with the meshed technique was evaluated. Forty-eight patients (72 breasts) with a mean age of 48.5?±?15.0 years (range 26?70 years) were included in the study. The mean follow-up time was 13.2?±?4.4 months (range 4.1?25.8 months). Nineteen breasts (24.6%) experienced complications, with seromas being the most common complication (12.5%, n?=?9). Expander removal and reoperation occurred at a rate of 8.3 and 9.7%, respectively. The average time to drain removal was 18.8?±?6.6 days (range 8?32 days). Meshed ADM provided an average cost savings of $6,601 for unilateral and $13,202 for bilateral reconstructions. Our study found that human-derived meshed ADM can be safely used in two-staged prepectoral tissue expander-based breast reconstruction and can result in significant cost savings.
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KEYWORD
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acellular dermal matrix, prepectoral, breast reconstruction, meshed, case reports
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