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Frey JD, Alperovich M, Weichman KE, et al. Breast Reconstruction Using Contour Fenestrated AlloDerm: Does Improvement in Design Translate to Improved Outcomes?. Plast Reconstr Surg Glob Open. 2015;3(9):e505doi: 10.1097/GOX.0000000000000482.
Frey, J. D., Alperovich, M., Weichman, K. E., Wilson, S. C., Hazen, A., Saadeh, P. B., Levine, J. P., Choi, M., & Karp, N. S. (2015). Breast Reconstruction Using Contour Fenestrated AlloDerm: Does Improvement in Design Translate to Improved Outcomes?. Plastic and reconstructive surgery. Global open, 3(9), e505. https://doi.org/10.1097/GOX.0000000000000482
Frey, Jordan D, et al. "Breast Reconstruction Using Contour Fenestrated AlloDerm: Does Improvement in Design Translate to Improved Outcomes?." Plastic and reconstructive surgery. Global open vol. 3,9 (2015): e505. doi: https://doi.org/10.1097/GOX.0000000000000482
Frey JD, Alperovich M, Weichman KE, Wilson SC, Hazen A, Saadeh PB, Levine JP, Choi M, Karp NS. Breast Reconstruction Using Contour Fenestrated AlloDerm: Does Improvement in Design Translate to Improved Outcomes?. Plast Reconstr Surg Glob Open. 2015 Sep 04;3(9):e505. doi: 10.1097/GOX.0000000000000482. eCollection 2015 Sep. PMID: 26495218; PMCID: PMC4596430.
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Plast Reconstr Surg Glob Open. 2015 Sep 04;3(9):e505. doi: 10.1097/GOX.0000000000000482. eCollection 2015 Sep.

Breast Reconstruction Using Contour Fenestrated AlloDerm: Does Improvement in Design Translate to Improved Outcomes?.

Plastic and reconstructive surgery. Global open

Jordan D Frey, Michael Alperovich, Katie E Weichman, Stelios C Wilson, Alexes Hazen, Pierre B Saadeh, Jamie P Levine, Mihye Choi, Nolan S Karp

Affiliations

  1. Department of Plastic Surgery, NYU Langone Medical Center, New York, N.Y.; and Division of Plastic and Reconstructive Surgery, Montefiore Medical Center, New York, N.Y.

PMID: 26495218 PMCID: PMC4596430 DOI: 10.1097/GOX.0000000000000482

Abstract

BACKGROUND: Acellular dermal matrices are used in implant-based breast reconstruction. The introduction of contour fenestrated AlloDerm (Life-Cell, Branchburg, N.J.) offers sterile processing, a crescent shape, and prefabricated fenestrations. However, any evidence comparing reconstructive outcomes between this newer generation acellular dermal matrices and earlier versions is lacking.

METHODS: Patients undergoing implant-based breast reconstruction from 2010 to 2014 were identified. Reconstructive outcomes were stratified by 4 types of implant coverage: aseptic AlloDerm, sterile "ready-to-use" AlloDerm, contour fenestrated AlloDerm, or total submuscular coverage. Outcomes were compared with significance set at P < 0.05.

RESULTS: A total of 620 patients (1019 reconstructions) underwent immediate, implant-based breast reconstruction; patients with contour fenestrated AlloDerm were more likely to have nipple-sparing mastectomy (P = 0.0001, 0.0004, and 0.0001) and immediate permanent implant reconstructions (P = 0.0001). Those with contour fenestrated AlloDerm coverage had lower infection rates requiring oral (P = 0.0016) and intravenous antibiotics (P = 0.0012) compared with aseptic AlloDerm coverage. Compared with sterile "ready-to-use" AlloDerm coverage, those with contour fenestrated AlloDerm had similar infection outcomes but significantly more minor mastectomy flap necrosis (P = 0.0023). Compared with total submuscular coverage, those with contour fenestrated AlloDerm coverage had similar infection outcomes but significantly more explantations (P = 0.0001), major (P = 0.0130) and minor mastectomy flap necrosis (P = 0.0001). Significant independent risk factors for increased infection were also identified.

CONCLUSIONS: Contour fenestrated AlloDerm reduces infections compared with aseptic AlloDerm, but infection rates are similar to those of sterile, ready-to-use AlloDerm and total submuscular coverage.

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