%0 Journal Article
%T Human Acellular Dermis versus Submuscular Tissue Expander Breast Reconstruction: A Multivariate Analysis of Short-Term Complications
%A Armando A. Davila
%A Akhil K. Seth
%A Edward Wang
%A Philip Hanwright
%J Archives of Plastic Surgery
%D 2013
%I The Korean Society of Plastic and Reconstructive Surgeons
%R http://dx.doi.org/10.5999/aps.2013.40.1.19
%X Background Acellular dermal matrix (ADM) allografts and their putative benefits have beenincreasingly described in prosthesis based breast reconstruction. There have been a myriadof analyses outlining ADM complication profiles, but few large-scale, multi-institutionalstudies exploring these outcomes. In this study, complication rates of acellular dermis-assistedtissue expander breast reconstruction were compared with traditional submuscular methodsby evaluation of the American College of Surgeon¡¯s National Surgical Quality ImprovementProgram (NSQIP) registry.Methods Patients who underwent immediate tissue expander breast reconstruction from2006-2010 were identified using surgical procedure codes. Two hundred forty tracked variablesfrom over 250 participating sites were extracted for patients undergoing acellular dermisassistedversus submuscular tissue expander reconstruction. Thirty-day postoperative outcomesand captured risk factors for complications were compared between the two groups.Results A total of 9,159 patients underwent tissue expander breast reconstruction; 1,717using acellular dermis and 7,442 with submuscular expander placement. Total complicationsand reconstruction related complications were similar in both cohorts (5.5% vs. 5.3%, P=0.68and 4.7% vs. 4.3%, P=0.39, respectively). Multivariate logistic regression revealed body massindex and smoking as independent risk factors for reconstructive complications in both cohorts(P<0.01).Conclusions The NSQIP database provides large-scale, multi-institutional, independentoutcomes for acellular dermis and submuscular breast reconstruction. Both thirty-daycomplication profiles and risk factors for post operative morbidity are similar between thesetwo reconstructive approaches.
%K Alloderm
%K Mammaplasty
%K Breast implantation
%K Tissue expansion devices
%K Complications
%U http://www.e-aps.org/Synapse/Data/PDFData/2023APS/aps-40-19.pdf