Abstract 91: Alternatives to ADM: Utilization of a Gore DualMesh Sling as a Cost Conscious Adjunct for Breast Reconstruction

Abstract

PURPOSE: This study seeks an alternative to acellular dermal matrix (ADM) in two staged breast reconstruction while minimizing cost. It was hypothesized that use of a Gore DualMesh would allow for similar intraoperative tissue expander fill volumes, time to 2nd stage, and number of post-operative fills compared to ADM at only a fraction of the expense. METHODS: Retrospective analysis comparing Gore DualMesh (34 patients, 59 breasts), ADM (8 patients, 13 breasts) and total muscle coverage (14 patients, 25 breasts) for post-mastectomy breast reconstruction was performed. Time to 2nd stage, number of expansions, and relative initial fill volumes were compared between the 3 groups. Complication rates were also considered, including seroma, infection, expander/implant explantation, removal of mesh, and capsular contracture. Statistical analysis was performed utilizing Fisher exact test and chi-squared test for categorical variables and Mann-Whitney U test for continuous variables. RESULTS: Time to 2nd stage, number of expansions, and relative initial fill volumes showed no statistical difference between the ADM and Gore DualMesh groups (p=0.539, 0.146 and 0.494 respectively). Furthermore, the Gore DualMesh group underwent significantly fewer fills (p<0.001) and had a higher relative initial fill volume (p<0.001) compared to total muscle coverage. The additional cost per breast as a result of including DualMesh was on average $385 versus $4287 for ADM. Complication rates were similar between all three groups without statistically significant differences. CONCLUSION: Gore DualMesh represents a safe alternative to ADM for breast reconstruction with similar aesthetic results at a fraction of the cost.