Local reaction to FlexHD® acellular dermal matrix in breast reconstruction: A case report and review of the literature

Robert Phan,Frank Lin ,Dean C White

doi:10.34239/ajops.v1i1.6

Abstract

Since its first reported use for the treatment of burns victims, acellular dermal matrix (ADM) use has expanded to surgeries including repairing thoracic and abdominal wall defects, and breast reconstruction. FlexHD® is a brand of ADM prepared from human cadaveric dermis that has been processed to remove antigenic components and is used to reinforce the subpectoral pocket created during submuscular breast implant surgery. Recent documentation of a phenomenon termed ‘red breast syndrome’ (RBS) has emerged in the medical literature, with little known about its aetiology and treatment. This paper presents a case of blistering cutaneous erythema from FlexHD® ADM.

Highlights

Since its first reported use for the treatment of burns victims, acellular dermal matrix (ADM) use has expanded to surgeries including repairing thoracic and abdominal wall defects, and breast reconstruction
FlexHD® (125 May St, Edison, NJ 08837, United States) is a brand of ADM prepared from human cadaveric dermis that has been processed to remove antigenic components and is used to reinforce the subpectoral pocket created during submuscular breast implant surgery
This paper presents a case of blistering cutaneous erythema from FlexHD® ADM, reviews the current literature on red breast syndrome’ (RBS) and proposes a treatment methodology

Summary

Conclusion

The aetiology, risk factors and treatment of RBS red breast syndrome are elusive. While the presentations of RBS can be varied, the current literature, as well as our case, demonstrate that RBS is primarily characterised by a cutaneous erythema over the region of an inserted ADM. The presence or absence of systemic symptoms should not be the primary determining factor in stratifying RBS from infection, but rather the presence or absence of stable erythema. Further recognition and study of this condition is required to determine cause and appropriate treatment. Consent to publish Patients signed informed consent regarding publishing their data and photographs. Disclosure The authors have no conflicts of interest to disclose. Funding The authors received no financial support for the research, authorship, and/or publication of this article

Introduction

Discussion

Findings

Summary of features of RBS