Use of 801 Acellular Dermal Matrices (ADMs) in Direct-to-Implant Breast Reconstruction: A Clinical Observation of Complication Profiles Over a 7-Year Period.

Abstract

The emergence of acellular dermal matrices (ADMs) revolutionized pre-pectoral breast reconstruction, allowing partial or complete implant coverage. ADM had been described to possess several important benefits, nevertheless literature described increased postoperative complication rate. Delineate the senior author experience with ADM (DermaCell; Stryker, Kalamazoo, MI) in direct-to-implant (DTI) breast reconstruction. Describe complication rate and patient's satisfaction. This is a retrospective patients cohort, undergoing primary or revisionary breast reconstruction (DTI), utilizing DermaCell, from Jan 2017 to Jan 2024. 230 consecutive patients, 410 breasts, 801 DermaCell sheets were evaluated. All were DTI breast reconstructions. Complication rate were described per breast. Total of 92 cases of complication occurred (22.4%). Rippling was seen in eighteen breasts (4.39%), skin ischemia in twenty-one breast (5.12%), hematoma in five (1.21%), seroma in nine (2.19%). 17 breasts experienced capsular contraction. In the non-irradiated group, capsular contracture (CC), baker grade 3-4, was seen in four breasts (1.11%) and nine (18%) in the irradiated group. Postoperative follow up period was 18 months (range: 6-84 months).BREAST-Q: satisfaction with breast increased by a mean of 10.45. Satisfaction with the implant was 6.61 out of 8. This cohort represents the most comprehensive and up-to-date experience with DermaCell (ADM) for direct-to-implant (DTI) breast reconstructive surgery. The favorable complication profile suggests that ADM offers a safe and reliable option, making it an important tool in the armamentarium of the reconstructive plastic surgeon. DermaCell is an important component in pre-pectoral breast reconstruction, contributing to better results, improved complication profile and patient's satisfaction.