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Acellular dermal matrix

Nicholas M Pantelides, Jeyaram R Srinivasan
BACKGROUND: Implant rippling is a frequent complication following breast augmentation or implant-based reconstruction and results in significant patient dissatisfaction. Traditionally, the treatment has been to replace the implant, often placing it in a subpectoral pocket to reduce the risk of recurrence. Other techniques, such as increasing the implant size or tightening the capsule, can also be used. Recently, however, there has been much interest in alternative treatments, including fat grafting or insertion of an acellular dermal matrix...
March 15, 2018: Aesthetic Plastic Surgery
Tae Hwan Park, Soon Won Chung, Seung Yong Song, Dae Hyun Lew, Tai Suk Roh, Dong Won Lee
Although there is ample evidence showing that radiation therapy increases the risk of complications of breast reconstruction, the efficacy of human acellular dermal matrix (CGCryoDerm®) in immediate tissue expander breast reconstruction in the setting of postmastectomy radiation therapy has not been fully elucidated. In this study, we report our institutional experience with pertinent refined surgical technique, and determine whether acellular dermal matrices have a protective effect in this increasingly prevalent clinical setting...
March 6, 2018: Journal of Materials Science. Materials in Medicine
Douglas H Mahn
Proper surgical techniques can permit treatment of multiple gingival recession defects without altering the visible gingival pigmentation. In this case report, a patient presented with multiple adjacent sites displaying gingival recession. Natural pigmentation was present in the interdental papillae and in the zone of keratinized gingiva. This patient wanted his natural pigmentation to be preserved. A modified tunnel technique was used to avoid traumatizing the pigmented tissues and allow placement of a large graft...
March 2018: Compendium of Continuing Education in Dentistry
Vishal N Shah, Oleg Orlov, Ryan Hoffman, Konstadinos Plestis
The number of chest wall reconstructions with a biologic mesh is increasing, but its long-term durability is unproven. A 73-year-old man underwent a complex sternal reconstruction 7 years ago with porcine acellular dermal matrix after postoperative repair of his ruptured right ventricle after coronary artery bypass grafting. He recently presented with unstable angina. Cardiac catheterization showed occluded saphenous vein grafts, and the patient required repeat coronary artery bypass grafting. Upon re-entry into the chest, the mesh was completely incorporated into the surrounding tissues and maintained long-term durability...
February 26, 2018: European Journal of Cardio-thoracic Surgery
Gloria R Sue, Beatrice J Sun, Gordon K Lee
BACKGROUND: Two-stage expander implant breast reconstruction is commonly performed after mastectomy. Salvage and long-term outcomes after development of complications have not been well described. We examined a single surgeon's experience to study the rate of reoperation secondary to complications after first-stage expander placement and to evaluate their outcomes. Better understanding of salvage techniques may help guide future management. METHODS: We performed a retrospective analysis of consecutive patients who underwent placement of a tissue expander (TE) for breast reconstruction between December 2006 and August 2015 with the senior author...
February 27, 2018: Annals of Plastic Surgery
Patrick Bletsis, Alexandra Bucknor, Anmol Chattha, Parisa Kamali, Austin Chen, Renata Flecha-Hirsch, Berend van der Lei, Bernard T Lee, Samuel J Lin
BACKGROUND: Over the last decade, there has been a 12% increase in prophylactic mastectomy (PM) per year. The aim of the study was to analyze complication rates and associated risk factors in patients undergoing PM and reconstruction. METHODS: We reviewed patients undergoing PM (contralateral and bilateral) from 2010 to 2015 at a single academic institution. Data on patient characteristics and postoperative outcomes were obtained. Postoperative complications were categorized into minor and major groups...
February 23, 2018: Annals of Plastic Surgery
Jake X Checketts, Joshua Gordon, Julia H Crawford, Haley Adams, Laurie Duckett, Matt Vassar
BACKGROUND: It has been estimated that up to 85 percent of research is of limited value or wasted, in part because of the wrong research questions being addressed. In this study, the authors identified research gaps for breast reconstruction using guideline recommendations based on low-quality or no evidence. The authors then evaluated whether research was currently being conducted to fill these gaps. METHODS: The authors extracted grade C and D options, which are based on limited evidence, from the American Society of Plastic Surgeon's clinical practice guideline for breast reconstruction...
March 2018: Plastic and Reconstructive Surgery
Nikhil Sobti, Emily Ji, Rebecca L Brown, Curtis L Cetrulo, Amy S Colwell, Jonathan M Winograd, William G Austen, Eric C Liao
BACKGROUND: Although many studies have examined the safety of acellular dermal matrix in immediate prosthetic breast reconstruction, few studies have evaluated efficacy. This study examined initial tissue expander fill volume as a marker of efficacy, comparing patients after staged prosthetic breast reconstruction assisted with acellular dermal matrix versus breast reconstruction not assisted with acellular dermal matrix. Number of fill visits and time interval to implant exchange were examined as secondary endpoints...
March 2018: Plastic and Reconstructive Surgery
Lene Nyhøj Heidemann, Gudjon L Gunnarsson, C Andrew Salzberg, Jens Ahm Sørensen, Jørn Bo Thomsen
Background: Acellular dermal matrix was introduced in breast reconstruction in 2001 and is gradually becoming a standard component for immediate breast reconstruction and nipple-sparing mastectomy. The reconstructive technique allows for improved aesthetic outcomes. However, there seems to be uncertainty regarding complication rates. The aim of this review was to systematically evaluate complication rates related to this method. Methods: This systematic review was conducted according to the recommendations outlined in the Cochrane Handbook for reviews and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement...
January 2018: Plastic and Reconstructive Surgery. Global Open
Alain J Azzi, Dino Zammit, Lucie Lessard
Background: When tissue expansion is necessary in breast reconstruction, a single-stage approach is possible using adjustable expander/implants, with or without the use of acellular dermal matrix. We aimed to present the senior author's single-stage experience over a period of 12 years using combined expander/implants in breast reconstruction. Methods: This is a Single-institution, retrospective review of breast reconstruction with combined expander/implants from 2002 to 2014...
January 2018: Plastic and Reconstructive Surgery. Global Open
Salvatore A Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: We evaluated the incidence of and the risk factors for readmission in patients who underwent abdominal wall reconstruction (AWR) using acellular dermal matrix (ADM) and assess whether readmission affects AWR long-term outcomes. METHODS: A retrospective, single-center study of patients underwent AWR with ADM was conducted. The primary outcome was the incidence of unplanned readmission within 30 days after the initial discharge post-AWR. Secondary outcomes were surgical site occurrence (SSO) and hernia recurrence at follow-up...
February 5, 2018: American Journal of Surgery
Xiangliang Xu, Nianhui Cui, Enbo Wang
Acellular dermal matrices (ADMs) are increasingly used for the restoration of soft-tissue defects of the oral cavity due to their ability to facilitate faster healing and reduce scar formation without rejection. However, few studies have focused on the histopathology and biological mechanisms involved in their use. The aim of the present study was to observe tissue growth, histopathologic changes and altered biomolecular signatures that occur during the repair of oral defects in rabbit models over time, either with or without the employment of ADM...
March 2018: Experimental and Therapeutic Medicine
Isabele Carrilho Jarros, Érika Okuno, Maiara Ignacio Costa, Flávia Franco Veiga, Patricia de Souza Bonfim-Mendonça, Melyssa Fernanda Norman Negri, Terezinha Inez Estivalet Svidzinski
In recent decades, the prognosis for burn patients has improved considerably with the development of specialized care. The acellular dermal matrix (ADM) is a totally artificial acellular device that functions to control water loss, prevent penetration by bacteria and allow migration of endothelial cells and fibroblasts from patient tissues. However, little is known about its effectiveness against yeasts. The present study evaluated the capacity of colonization and migration of some human commensal yeasts. Three clinical isolates from skin scales, identified as Candida parapsilosis, Candida glabrata and Rhodotorula mucilaginosa, were used...
February 8, 2018: Microbial Pathogenesis
Xiao-Dong Chen, Shu-Bin Ruan, Ze-Peng Lin, Ziheng Zhou, Feng-Gang Zhang, Rong-Hua Yang, Ju-Lin Xie
Skin wound healing involves Notch/Jagged1 signaling. However, little is known how Jag1 expression level in epidermal stem cells (ESCs) contributes to wound healing and scar formation. We applied multiple cellular and molecular techniques to examine how Jag1 expression in ESCs modulates ESCs differentiation to myofibroblasts (MFB) in vitro, interpret how Jag1 expression in ESCs is involved in wound healing and scar formation in mice, and evaluate the effects of porcine acellular dermal matrix (ADM) treatment on wound healing and scar formation...
February 8, 2018: Organogenesis
Umar Wazir, Kefah Mokbel
INTRODUCTION: The increasing use of acellular dermal matrix (ADM) and fat transfer in the context of breast reconstruction, following skin sparing mastectomy (SSM) for therapeutic and risk reducing purposes, combined with the need to eliminate animation deformities, reduce post-operative dysfunctional pain and the risk of capsular contracture, has prompted surgeons to investigate the possibility of placing the mammary implant over the pectoralis major muscle with complete coverage with ADM thus reviving the pre-pectoral approach which was previously abandoned due to high complications rates and poor aesthetics in the pre-ADM era...
February 2, 2018: American Journal of Surgery
Luc Joyeux, Felix De Bie, Enrico Danzer, Tim Van Mieghem, Alan W Flake, Jan Deprest
OBJECTIVE: To determine the safety and efficacy of different neurosurgical techniques for closure of spina bifida (SB) in the fetal lamb model. METHOD: Systematic review of studies reporting on fetal lambs undergoing induction and closure of SB compared to non-operated normal lambs (negative controls) and/or lambs not undergoing closure of the defect (positive controls). Primary outcomes were (1) survival at birth (safety) and/or (2) presence of Somatosensory Evoked Potentials on hind limbs and/or improvement in quantitative histological spinal cord findings and/or reversal of hindbrain herniation (efficacy)...
January 31, 2018: Prenatal Diagnosis
Dogeon Yoon, Dajeong Yoon, Hyuk-Jin Cha, Ji-Seon Lee, Wook Chun
The use of artificial dermis as a skin substitute represents a field of active study, as acellular dermal matrices from cadavers are susceptible to infection owing to their human origin. One such alternative dermal replacement scaffold, INSUREGRAF®, is derived primarily from extracellular matrix proteins such as collagen and elastin and has been clinically used to treat severe skin wounds such as burns. This scaffold has proven to be useful to minimize wound contraction and scar formation owing to its biocompatibility, interconnected pore structure, sufficient biodegradability, and suitable mechanical properties...
February 1, 2018: Biomedical Materials
Fayyaz A K Mazari, Ghulam M Wattoo, Nazar H Kazzazi, Kadappa M Kolar, Olumuyiwa O Olubowale, Clare E Rogers, Iman A Azmy
BACKGROUND: Strattice (porcine derivative) and SurgiMend (bovine derivative) are the two most common acellular dermal matrices used in breast reconstruction in the United Kingdom. This retrospective study compared clinical outcomes in immediate implant-based breast reconstruction patients. METHODS: The study, conducted across three hospitals, included all patients who underwent immediate implant-based breast reconstruction using Strattice and SurgiMend. The primary outcome measure was implant loss rate...
February 2018: Plastic and Reconstructive Surgery
Brielle Weinstein, Ambuj Kumar, Paul Smith, Deniz Dayicioglu
BACKGROUND: Tissue expander and implant remains the most common technique for breast reconstruction. A controversial topic within this method is routine use of acellular dermal matrix (ADM). Acellular dermal matrices have increased risks of infection, seroma, hematoma, skin flap necrosis, and total complications. METHODS: After an institutional review board approval, a retrospective chart review was conducted of 756 tissue expander with implant cases from November 2010 to November 2016 at Moffitt Cancer Center with 2 breast reconstruction surgeons...
January 24, 2018: Annals of Plastic Surgery
Kyeong-Tae Lee, Yeseul Eom, Goo-Hyun Mun, Sa Ik Bang, Byung-Joon Jeon, Jai-Kyong Pyon
BACKGROUND: Acellular dermal matrix (ADM), popularly used in tissue expander-based breast reconstruction, is applied either as a partial or full sling, but without any consensus regarding which method of application produces better outcomes. We aimed to compare the outcomes between two patient groups who underwent tissue expander-based breast reconstruction using these techniques. METHODS: A retrospective review was conducted for consecutive patients who underwent immediate two-stage implant-based breast reconstruction using ADM between January 2013 and June 2016...
January 24, 2018: Aesthetic Plastic Surgery
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