Acellular Dermal Matrix (ADM) in Breast Reconstruction

In a meta-analysis of 16 studies, ADM was found to be associated with a higher likelihood of seroma (pooled OR, 3.9; 95% CI, 2.4-6.2), infection (pooled OR, 2.7; 95% CI, 1.1-6.4), and reconstructive failure (pooled OR, 3.0; 95% CI, 1.3-6.8).

The rates of hematoma (pooled OR, 2.0; 95% CI, 0.8-5.2), cellulitis (pooled OR, 2.0; 95% CI, 0.9-4.3), and skin flap necrosis (pooled OR, 1.9; 95% CI, 0.6-5.4) were not significantly different from reconstruction without ADM.

Furthermore, in a randomized controlled trial, use of ADM had no effect on postoperative pain and narcotic use, nor on the rate at which tissue expanders could be expanded.

Ho G, Ngueyen TG, Shahabi A, Hwang BH, Chan LS, Wong AK. A systematic review and meta-analysis of complications associated with acellular dermal matrix-associated reconstruction. Ann Plast Surg. 2012;68:346-356.

McCarthy CM, Lee CN, Halvorson EG, et al.The use of acellular dermal matrices in two-stage expander/implant reconstruction:  a multicenter, blinded, randomized controlled trial. Plast Reconstr Surg 2012;130(5 Suppl 2):57S-66S.

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