AlloDerm RTU Integration and Clinical Outcomes When Used for Reconstructive Breast Surgery

Background: AlloDerm Ready To Use (RTU) is a sterile version of AlloDerm regenerative tissue matrix, developed in response to concerns regarding the potential risk of infectious complications with the latter aseptic matrix. Clinical data on AlloDerm RTU use is, however, limited, particularly with respect to histologic evidence of graft integration and clinical outcomes. Methods: Consecutive patients who underwent tissue-expander/implant reconstruction with the use of AlloDerm RTU from March 2011 to September 2012 were included in this analysis. Biopsies of AlloDerm RTU/capsule interface were obtained at the time of expander/implant exchange and evaluated for evidence of cellularization, vascularization, and inflammatory reaction. Data on postoperative complications were retrieved from patient records. Results: A total of 116 biopsy specimens from 68 patients were obtained. At biopsy, on visual inspection, nearly all grafts were fully integrated within the host tissue. Histologically, graft specimens demonstrated mild-to-moderate neovascularization and cellular repopulation with no inflammatory cells. All patients were followed for 5 years postoperatively. Short-term postoperative complications of skin necrosis, seroma, and infection occurred in 10.3%, 4.3%, and 2.6% of reconstructions, respectively. Capsular contracture (grade 3) was the only long-term complication (5.2%). Rates of short- and long-term complications are similar to those observed in our previous experience with AlloDerm reconstructive tissue matrix. Conclusions: AlloDerm RTU used in breast reconstructive surgery fully integrates and incorporates into host tissue. There were no unexpected safety concerns with its use at short-term or at long-term, at least up to 5 years of follow-up.