Journal of Plastic, Reconstructive & Aesthetic Surgery
Use of acellular cadaveric dermis and tissue expansion in postmastectomy breast reconstruction
Section snippets
Patients and methods
We performed a retrospective chart review of all patients who underwent staged tissue expansive breast reconstruction at two institutions between July 2004 and July 2005 performed by our two senior authors, DJL and DAK. Our patient population includes 41 patients for a total of 65 breast reconstructions that used ACD for tissue expander coverage (and subsequent implant coverage). We analysed these charts with particular emphasis on determining rates of postoperative complications inclusive of
Results
Among the 41 patient (65 breasts), 24 underwent bilateral reconstructions and the remaining 17 underwent unilateral reconstruction. All cases were performed immediately after the general surgeon completed each mastectomy. Forty-seven of 65 breasts had expander exchange with silicone permanent implant and 18 with saline. Patients expected to require radiation postoperatively were not recommended to undergo implant-based reconstruction because of poor results reported by others.13, 14 However
Discussion
In our case series, the rate of wound infection was minimal (Table 1). In only one case, the ACD and tissue expander were removed due to a deep wound infection. However, this occurred in a patient who underwent radiation therapy to that breast. Her infection resolved after removal of the prosthesis and a short course of i.v. antibiotics. She is currently in the preoperative planning stage for an autologous flap reconstruction.
In our series the rate of major complications with postoperative
References (22)
One hundred free DIEP flap breast reconstructions: a personal experience
Br J Plast Surg
(1999)- et al.
Vaginal paravaginal repair with an alloderm graft
Am J Obstet Gynecol
(2003) - et al.
The transverse rectus abdominis musculocutaneous free flap: a reliable alternative for delayed autologous tissue breast reconstruction
Ann Plast Surg
(1990) - et al.
Immediate breast reconstruction in breast cancer: morbidity and outcome
Am Surg
(1998) - et al.
Breast reconstruction
Cancer
(1994) - et al.
Aesthetic breast reconstruction using a combination of free transverse rectus abdominis musculocutaneous flaps and breast implants
Ann Plast Surg
(1996) - et al.
Implant reconstruction in breast cancer patients treated with radiation therapy
Plast Reconstr Surg
(2006) - et al.
Aesthetic aspects of breast reconstruction
Aesthetic Plast Surg
(1982) - et al.
Complete one-stage, immediate breast reconstruction with prosthetic material in patients with large or ptotic breasts
Plast Reconstr Surg
(2002) - et al.
Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings
Ann Plast Surg
(2005)