Abstract
Background. Decellularized human skin has been used in a variety of medical applications, primarily involving soft tissue reconstruction, wound healing, and tendon augmentation. Theoretically, decellularization removes potentially immunogenic material and provides a clean scaffold for cellular and vascular in growth. The use of acellular dermal matrix in two-stage postmastectomy breast reconstruction is described. Methods. Ten consecutive breast cancer patients were treated with mastectomies and immediate reconstruction from August to November 2011. There were 8 bilateral and 1 unilateral mastectomies for a total of 17 breasts, with one exclusion for chronic tobacco use. Reconstruction included the use of a new 6 × 16 cm sterile, room temperature acellular dermal matrix patch (DermACELL) soaked in a cefazolin bath. Results. Of the 17 breasts, 15 reconstructions were completed; 14 of them with expander to implant sequence and acellular dermal matrix. Histological analysis of biopsies obtained during trimming of the matrix at the second stage appeared nonremarkable with evidence of normal healing, cellularity, and vascular infiltration. Conclusion. Postoperative observations showed that this cellular dermal matrix appears to be an appropriate adjunct to reconstruction with expanders. This acellular dermal matrix appeared to work well with all patients, even those receiving postoperative chemotherapy, postoperative radiation, prednisone, or warfarin sodium.
Highlights
For breast cancer patients, the use of expanders and/or implants is the most common method of breast reconstruction following mastectomy [1]
All eligible patients were included with criteria for exclusion being tobacco use or a known planned course of postoperative radiation after mastectomy
A demarcation line between the matrix and native capsule was noted, the matrix was incorporated at this line
Summary
The use of expanders and/or implants is the most common method of breast reconstruction following mastectomy [1]. This typically involves a twostage process where tissue expanders are placed postmastectomy and filled gradually for a period of several months. Once the desired expander volume is reached, the second reconstructive stage involves replacing the expanders with silicone implants Another reconstruction option is the use of autologous tissue from a separate patient site to supply needed skin for wound closure at the mastectomy site. The use of acellular dermal matrix in two-stage postmastectomy breast reconstruction is described. This acellular dermal matrix appeared to work well with all patients, even those receiving postoperative chemotherapy, postoperative radiation, prednisone, or warfarin sodium
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