By Richard E. Baxter
Topics comprise: Defining the problem/proof of suggestion; The reconstructive version; Do ADM's switch the explanation for fast vs. delayed?; Direct to implant reconstruction; Capsular contracture and ADM's; Pocket reinforcement/bottoming out; ADM's within the irradiated breast; rising purposes; comparability of alternative ADM fabrics; guidance and pearls; monetary concerns
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Extra resources for Acellular Dermal Matrices in Breast Surgery, an Issue of Clinics in Plastic Surgery
This article focuses on the contribution of ADMs to immediate breast reconstruction. The current literature on ADMs is reviewed and the potential advantages and disadvantages of their use are highlighted. Technical considerations on how to effectively use these materials is presented. 2 In 2010, 93,083 breast reconstruction procedures were performed. This number is an increase of 8% from 2009. Most patients underwent a 2-stage reconstruction with a tissue expander and implant (62,081). 3 In the years ahead, the number of women who will undergo immediate reconstruction is likely to increase.
Their study describes an innovative use of ADM and redundant local tissue to improve a previously described technique for immediate reconstruction. A caveat is that the Wise-pattern technique is only appropriate for patients with large breasts, who tend to have redundant skin after parenchymal resection. Generally, successful single-stage, direct-to-implant reconstruction with ADM requires well-perfused, viable mastectomy skin flaps, and a reconstruction that is similar to, or smaller than, the original volume of the breast.
8. A. Salzberg. Nonexpansive immediate breast reconstruction using human acellular tissue matrix graft (AlloDerm). Ann Plast Surg. 2006;57(1):1-5. 9. B. Preminger, C. McCarthy, Q. Hu, et al. The influence of AlloDerm on expander dynamics and complications in the setting of immediate tissue expander/implant reconstruction: a matched-cohort study. Ann Plast Surg. 2008;60(5):510-513. 10. A. Antony, C. McCarthy, P. Cordeiro, et al. Acellular human dermis implantation in 153 immediate two-stage tissue expander breast reconstructions: determining the incidence and significant predictors of complications.