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Keyianoosh Z Paydar, Garrett A Wirth, Donald S Mowlds
Fenestrated acellular dermal matrix (ADM) has improved patient outcomes in both direct-to-implant and 2-stage tissue expander/implant breast reconstruction. This technical alteration utilizes optimal fenestration overlap to enhance the breast reconstruction experience. We present a novel, surgeon-designed shaped fenestrated ADM, placed in the recently repopularized prepectoral pocket for anterior coverage of implants in direct-to-implant and 2-stage breast reconstruction. A retrospective review of 10 patients (18 breasts) who underwent direct-to-implant or 2-stage breast reconstruction utilizing fenestrated shaped ADM in the prepectoral plane at a major academic institution in 2016 was conducted...
April 2018: Plastic and Reconstructive Surgery. Global Open
Kyeong-Tae Lee, Goo-Hyun Mun
BACKGROUND: The current diversity of the available acellular dermal matrix (ADM) materials for implant-based breast reconstruction raises the issue of whether there are any differences in postoperative outcomes according to the kind of ADM used. The present meta-analysis aimed to investigate whether choice of ADM products can affect outcomes. METHODS: Studies that used multiple kinds of ADM products for implant-based breast reconstruction and compared outcomes between them were searched...
July 2017: Annals of Plastic Surgery
Robert H Schnarrs, Claire M Carman, Chase Tobin, Serena A Chase, Kerri A Rossmeier
BACKGROUND: Human acellular dermal matrix (HADM) is commonly used to provide coverage and support for breast reconstruction. The primary purpose of this study was to evaluate the complication rates associated with breast reconstruction procedures when performed in conjunction with multiple types of HADM in a consecutive series. METHODS: After receiving institutional review board approval, medical records from a single surgeon were retrospectively reviewed for 126 consecutive patients (170 breasts and 211 procedures) who received a breast reconstruction or revision with implantation of HADM between 2012 and 2014...
November 2016: Plastic and Reconstructive Surgery. Global Open
Nikhil Sobti, Eric C Liao
BACKGROUND: The use of acellular dermal matrix has facilitated immediate prosthesis-based breast reconstruction. However, few studies directly compare surgical outcomes following acellular dermal matrix-based reconstruction with two of the most commonly available materials, AlloDerm and FlexHD. Those studies that are available often do not adequately control for the surgeon as a variable. The authors hypothesize that complication rates will not differ significantly between AlloDerm and FlexHD when practice and surgeon variables are properly controlled...
November 2016: Plastic and Reconstructive Surgery
Todd J Nilsen, Anouska Dasgupta, Yen-Chen Huang, Henry Wilson, Evangelia Chnari
BACKGROUND: The use of acellular dermal matrices (ADMs) has become the standard of practice in many reconstructive and aesthetic surgical applications. Different methods used to prepare the allograft tissue for surgical use can alter the ADMs natural properties. Aseptic processing has been shown to retain the natural properties of ADMs more favorably than terminally sterilized ADMs. Terminal sterilization has been historically linked to alteration of biological materials. In vitro work was conducted to compare ADM processing methods...
November 2016: Aesthetic Surgery Journal
Ciara R Huntington, Tiffany C Cox, Laurel J Blair, Samuel Schell, David Randolph, Tanushree Prasad, Amy Lincourt, B Todd Heniford, Vedra A Augenstein
BACKGROUND: Biologic mesh choice in ventral hernia repair is challenging due to lack of prospective data. This study examines long-term, single-center biologic mesh outcomes. METHODS: Prospective operative outcomes data was queried for open ventral hernia repair with biologic mesh. Univariate and multivariate analysis were used to compare mesh outcomes. RESULTS: In the study, 223 patients underwent open ventral hernia repair with biologic mesh, including 40 with Alloderm, 23 AlloMax, 70 FlexHD, 68 Strattice, and 22 Xenmatrix...
December 2016: Surgery
Michael M Vu, Gildasio S De Oliveira, Kristen E Mayer, Jordan T Blough, John Y S Kim
UNLABELLED: The value proposition of an acellular dermal matrix (ADM) taken from the deep dermis is that the allograft may be more porous, allowing for enhanced integration and revascularization. In turn, this characteristic may attenuate complications related to foreign body reactions, seromas, and infection. However, this is juxtaposed against the potential loss of allograft structural integrity, with subsequent risk of malposition and extrusion. Despite the active use of novel, deep dermal ADMs, the clinical outcomes of this new technology has not been well studied...
December 2015: Plastic and Reconstructive Surgery. Global Open
David A Palaia, Karen S Arthur, Anthony C Cahan, Michael H Rosenberg
BACKGROUND: Acellular dermal matrices (ADMs) provide clinical benefits in breast reconstruction but have been associated with increased postoperative complications, most frequently seromas. Fenestration of the ADM before insertion into the reconstructed breast may reduce the incidence of postoperative complications. In this retrospective analysis, postoperative complications were assessed after breast reconstruction with or without fenestrated ADMs. METHODS: Patients who underwent immediate 2-staged implant breast reconstructions using ADM at a single center were assessed...
November 2015: Plastic and Reconstructive Surgery. Global Open
Henry Benjamin Wilson
Breast cancer patients with significant comorbidities present reconstructive challenges due to a predictably high complication rate. During expander-based breast reconstruction, human acellular dermal matrix (ADM) is often used to prevent pectoralis muscle retraction, facilitate early expansion, and improve cosmetic outcome. Device infection and chronic seroma have been correlated to the addition of the graft by some large database reports but not others. This study describes the first reported experience with a new deep dermal ADM, FlexHD® Pliable™ (MTF, Edison, NJ)...
May 2015: Medicine (Baltimore)
Kyle C Ward, Kevin P Costello, Sara Baalman, Richard A Pierce, Corey R Deeken, Margaret M Frisella, L Michael Brunt, Brent D Matthews
PURPOSE: The objective of this study was to evaluate the performance of acellular human dermis reinforcement during laparoscopic hiatal hernia repair. METHODS: A prospective non-randomized, single institution study enrolled patients undergoing laparoscopic hiatal hernia repair. Acellular human dermis, FlexHD (Musculoskeletal Transplant Foundation, Edison, NJ) or AlloDerm (LifeCell Inc., Branchburg, NJ) were used to buttress the repair after primary closure. A protocol barium swallow (BAS) was performed at 6 months and then as needed due to clinical indications...
August 2015: Surgical Endoscopy
Grant V Bochicchio, Gerard P De Castro, Kelly M Bochicchio, Jennifer Weeks, Eduardo Rodriguez, Thomas M Scalea
BACKGROUND: Damage control surgery and management of the open abdomen has led to a significant improvement in survival in trauma and emergency surgical patients. However, subsequent abdominal reconstruction has become a significant challenge. The objective of this study was to compare 2 different acellular dermal matrices in regard to hernia recurrence and complications in patients who present with a large complicated ventral hernia as a result of trauma or emergency surgery. STUDY DESIGN: A prospective quasi-experimental time-interrupted series design was used to evaluate the incidence of hernia recurrence in trauma/emergency surgery patients who had a ventral hernia repair with a biologic matrix...
October 2013: Journal of the American College of Surgeons
Brett F Michelotti, Sebastian Brooke, John Mesa, Matthew Z Wilson, Kurtis Moyer, Donald R Mackay, Rogerio I Neves, John Potochny
With a rise in tissue expander-based breast reconstructions (TEBRs) using acellular dermal matrix (ADM), we have seen an increase in ADM-specific complications. In this study, we aimed to evaluate clinically significant seroma (CSS) formation-defined by the need for a drainage procedure-to determine if there was a difference in incidence between product types: AlloDerm (AL), DermaMatrix (DM), and FlexHD (FHD). This was a retrospective review of consecutive patients who underwent TEBR at a single institution...
September 2013: Annals of Plastic Surgery
Daniel Z Liu, David W Mathes, Peter C Neligan, Hakim K Said, Otway Louie
BACKGROUND: Prosthetic reconstruction using human acellular dermis (ADM) is a common practice in breast reconstruction. AlloDerm and FlexHD are two different forms of ADM, each with unique characteristics. No studies have directly compared the postoperative complications of these 2 products. METHODS: The outcomes of 547 consecutive implant-based breast reconstructions were reviewed. RESULTS: Reconstruction was performed in 382 consecutive women (547 total breasts), employing mostly immediate reconstruction (81%)...
May 2014: Annals of Plastic Surgery
Elizabeth N Fahrenbach, Chao Qi, Omer Ibrahim, John Y Kim, Murad Alam
IMPORTANCE: Acellular dermal matrices have many current and potential applications, but their long-term safety has not been extensively studied. In particular, limited information exists regarding such materials' resistance to infection. OBJECTIVE: To assess the resistance to microbial penetration of common acellular dermal matrix materials used in reconstruction after skin cancer excision, treatment of chronic ulcers and burns, breast reconstruction, hernia repairs, and other applications...
May 2013: JAMA Dermatology
Chandra V Ellis, David A Kulber
BACKGROUND: The goal of this article is to review the current literature on the use of acellular dermal matrix in forearm, wrist, and hand reconstruction. METHODS: A comprehensive literature search was performed using the Cochrane Database of Systematic Reviews, MEDLINE, PubMed, and Web of Knowledge. Articles were categorized as acellular dermal matrix used in soft-tissue repair and in ligament reconstruction. Search terms included "acellular dermal matrix," "biologic dressing," "skin replacement," "dermal allograft," "AlloDerm," "FlexHD," "Permacol," and "Strattice...
November 2012: Plastic and Reconstructive Surgery
Sebastian Brooke, John Mesa, Mehmet Uluer, Brett Michelotti, Kurtis Moyer, Rogerio I Neves, Donald Mackay, John Potochny
Acellular dermal matrix (ADM) is frequently used in tissue expander breast reconstruction (TEBR) for coverage of the inferior pole. Several published studies have suggested increased rates of complications with the use of ADM. It is unknown, however, if the type of ADM used for TEBR impacts complication rates. The aim of this study is to compare 3 different types of ADM for TEBR in regard to clinically significant complications, specifically infection. We performed a retrospective analysis of primary breast cancer-related TEBR with or without ADM...
October 2012: Annals of Plastic Surgery
Afua H Annor, Michael E Tang, Chi Lun Pui, Gregory C Ebersole, Margaret M Frisella, Brent D Matthews, Corey R Deeken
BACKGROUND: Biological scaffolds must support a complex balance of resisting enzymatic degradation while promoting tissue remodeling. Thus, the purpose of this study was to evaluate the effects of in vitro enzymatic exposure on the mechanical properties of biological scaffolds. It was hypothesized that exposure to an enzyme solution would result in decreased tensile strength and that crosslinked scaffolds would resist enzymatic degradation more effectively than noncrosslinked scaffolds...
October 2012: Surgical Endoscopy
Chi Lun Pui, Michael E Tang, Afua H Annor, Gregory C Ebersole, Margaret M Frisella, Brent D Matthews, Corey R Deeken
BACKGROUND: Coughing, bending, and lifting raise the pressure inside the abdomen, repetitively increasing stresses on the abdominal wall and the associated scaffold. The purpose of this study was to evaluate the effect of repetitive loading on biological scaffolds. It was hypothesized that exposure to repetitive loading would result in decreased tensile strength and that crosslinked scaffolds would resist these effects more effectively than non-crosslinked scaffolds. STUDY DESIGN: Nine materials were evaluated (porcine dermis: Permacol, CollaMend, Strattice, XenMatrix; human dermis: AlloMax, FlexHD; bovine pericardium: Veritas, PeriGuard; and porcine small intestine submucosa: Surgisis; in addition, Permacol, CollaMend, and PeriGuard are crosslinked)...
August 2012: Journal of the American College of Surgeons
Angela Cheng, Michel Saint-Cyr
This is a brief review of the history of the role of acellular dermal matrices in breast reconstruction surgery, with a summary of several currently available products, including a table of comparisons. Key features, including biologic tissue source, surgical preparation, sterility, polarity, contraindications, shelf life, and cost, are examined. A paucity of data exists to directly compare AlloDerm®, DermaMatrix®, Strattice™, Permacol™, DermACELL, FlexHD®, SurgiMend®, and ALLOMAX™ for breast reconstruction; most studies relate to hernia repair...
April 2012: Clinics in Plastic Surgery
Theodore T Nyame, Katherine P Lemon, Roberto Kolter, Eric C Liao
BACKGROUND: There has been increasing use of synthetic and acellular dermal matrix materials in surgery, ranging from breast reconstruction to hernia repairs. There is a paucity of data on how acellular dermal matrix compares with other surgical materials as a substrate for bacterial adhesion, the first step in formation biofilm, which occurs in prosthetic wound infections. The authors have designed a high-throughput assay to evaluate Staphylococcus aureus adherence on various synthetic and biologically derived materials...
November 2011: Plastic and Reconstructive Surgery
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