Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction
Background As the indications for postmastectomy radiotherapy expand, innovative solutions are required to reduce operative complications and reconstructive failure after prosthetic breast reconstruction. In this study, we investigated the effectiveness of acellular dermal matrix (ADM) inlay grafts...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2019-11-01
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| Series: | Archives of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2018.00073 |
| _version_ | 1828109316562878464 |
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| author | Mi Jung Kim Sung Jae Ahn Kenneth L. Fan Seung Yong Song Dae Hyun Lew Dong Won Lee |
| author_facet | Mi Jung Kim Sung Jae Ahn Kenneth L. Fan Seung Yong Song Dae Hyun Lew Dong Won Lee |
| author_sort | Mi Jung Kim |
| collection | DOAJ |
| description | Background As the indications for postmastectomy radiotherapy expand, innovative solutions are required to reduce operative complications and reconstructive failure after prosthetic breast reconstruction. In this study, we investigated the effectiveness of acellular dermal matrix (ADM) inlay grafts in preventing postoperative wound dehiscence of irradiated breasts in the context of prosthetic breast reconstruction.
Methods A retrospective analysis was conducted of 45 patients who received two-stage prosthetic reconstruction and radiotherapy following mastectomy. An ADM graft was placed beneath the incisional site during the second-stage operation in 19 patients using marionette sutures, whereas the control group did not receive the ADM reinforcement. Patient demographics and complications such as wound dehiscence, capsular contracture, peri-prosthetic infection, cellulitis, and seroma were compared between the two groups.
Results During an average follow-up period of 37.1 months, wound dehiscence occurred significantly less often in the ADM-reinforced closure group (0%) than in the non-ADM group (23.1%) (P=0.032). There was no significant difference between the two groups in relation to other complications, such as capsular contracture, postoperative infection, or seroma.
Conclusions The ADM inlay graft is a simple and easily reproducible technique for preventing incisional dehiscence in the setting of radiotherapy after prosthetic breast reconstruction. The ADM graft serves as a buttress to offload tension during healing and provides a mechanical barrier against pathogens. Application of this technique may serve to reduce complications in prosthetic breast reconstruction after radiotherapy. |
| first_indexed | 2024-04-11T11:01:31Z |
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| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-11T11:01:31Z |
| publishDate | 2019-11-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-0edf5c82f7a348c3b2b0170dd4a33f5e2022-12-22T04:28:34ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712019-11-01460654454910.5999/aps.2018.000733688Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstructionMi Jung Kim0Sung Jae Ahn1Kenneth L. Fan2Seung Yong Song3Dae Hyun Lew4Dong Won Lee5Department of Plastic and Reconstructive Surgery and Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, KoreaDepartment of Plastic and Reconstructive Surgery and Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, KoreaDepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington DC, USADepartment of Plastic and Reconstructive Surgery and Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, KoreaDepartment of Plastic and Reconstructive Surgery and Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, KoreaDepartment of Plastic and Reconstructive Surgery and Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, KoreaBackground As the indications for postmastectomy radiotherapy expand, innovative solutions are required to reduce operative complications and reconstructive failure after prosthetic breast reconstruction. In this study, we investigated the effectiveness of acellular dermal matrix (ADM) inlay grafts in preventing postoperative wound dehiscence of irradiated breasts in the context of prosthetic breast reconstruction. Methods A retrospective analysis was conducted of 45 patients who received two-stage prosthetic reconstruction and radiotherapy following mastectomy. An ADM graft was placed beneath the incisional site during the second-stage operation in 19 patients using marionette sutures, whereas the control group did not receive the ADM reinforcement. Patient demographics and complications such as wound dehiscence, capsular contracture, peri-prosthetic infection, cellulitis, and seroma were compared between the two groups. Results During an average follow-up period of 37.1 months, wound dehiscence occurred significantly less often in the ADM-reinforced closure group (0%) than in the non-ADM group (23.1%) (P=0.032). There was no significant difference between the two groups in relation to other complications, such as capsular contracture, postoperative infection, or seroma. Conclusions The ADM inlay graft is a simple and easily reproducible technique for preventing incisional dehiscence in the setting of radiotherapy after prosthetic breast reconstruction. The ADM graft serves as a buttress to offload tension during healing and provides a mechanical barrier against pathogens. Application of this technique may serve to reduce complications in prosthetic breast reconstruction after radiotherapy.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2018.00073mammaplastybreast implantationacellular dermisradiotherapycomplications |
| spellingShingle | Mi Jung Kim Sung Jae Ahn Kenneth L. Fan Seung Yong Song Dae Hyun Lew Dong Won Lee Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction Archives of Plastic Surgery mammaplasty breast implantation acellular dermis radiotherapy complications |
| title | Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction |
| title_full | Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction |
| title_fullStr | Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction |
| title_full_unstemmed | Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction |
| title_short | Inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction |
| title_sort | inlay graft of acellular dermal matrix to prevent incisional dehiscence after radiotherapy in prosthetic breast reconstruction |
| topic | mammaplasty breast implantation acellular dermis radiotherapy complications |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2018.00073 |
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