Abstract
Breast reconstruction after surgery for cancer has more and more become crucial for patients’ satisfaction and quality of life. Lately, thanks to the spread of medical devices like synthetic and biological meshes (Acellular Dermal Matrices: ADMs) and surgical techniques such as skin-sparing and nipple-sparing mastectomies, surgeons are allowed to perform immediate breast reconstruction, avoiding the use of tissue-expanders. ADMs-assisted breast reconstruction can be divided into prepectoral and submuscular dualplane technique. In the last decade, many surgeons adopted the prepectoral technique, in order to avoid the direct contact between the silicone implant and the host tissues and complications such as animation deformity, muscular impairment and migration of the prosthesis. ADMs create a scaffold that the host cells can colonize, thus allowing prosthetic integration and encapsulation and promoting at the same time new vascularization. We performed a brief review of the literature about the use of ADMs in prepectoral direct-to-implant breast reconstruction, also discussing about the costs and their impact on the healthcare system, and finally mentioning which may be the direction of future technology in this promising field of research.
Highlights
Breast cancer is the second most commonly diagnosed cancer worldwide, with an incidence of 2.088.850 and a mortality rate of 627,000
It can be performed as a two-stage technique, using a tissue expander followed by the implant of a permanent prosthesis, or as an immediate singlestage technique with direct implant of a prosthesis with or without the use of an autologous tissue [21]
Our research focused on papers about prepectoral reconstructions using Acellular dermal matrices (ADMs)
Summary
Breast cancer is the second most commonly diagnosed cancer worldwide, with an incidence of 2.088.850 and a mortality rate of 627,000. Thanks to the spread of devices to assess blood flow intraoperatively, of medical devices like synthetic and biological meshes (Acellular Dermal Matrices: ADMs) providing complete covering of implants [7,8,9], surgical techniques such as skin-sparing (SSM) and nipple-sparing mastectomies (NSM), surgeons are allowed to perform immediate breast reconstruction (IBR), avoiding the use of tissue-expanders [10]. Acellular Dermal Matrix in Prosthetic Breast Reconstructive Surgery with Prepectoral Technique: A Literature Review. Tissue processing removes the cellular antigens responsible for immunologic response, while preserving the structural matrix that stimulates angiogenesis and tissue regeneration They create a scaffold that the host cells can colonize, allowing prosthetic integration and encapsulation and promoting at the same time new vascularization [11,12,13]. This review briefly analyzes current literature about the use of ADMs in prepectoral direct-to-implant breast reconstruction
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