The Use of Porcine Acellular Dermal Matrix in Single-stage, Implant-based Immediate Breast Reconstruction: A 2-center Retrospective Outcome Study

Background: There have been many reported benefits of the usage of acellular dermal matrices (ADMs) in breast reconstruction. ADM reduces the need for rectus abdominis muscle and serratus anterior coverage by providing an inferolateral coverage of the implant/tissue expander. ADM can provide patients with a 1-staged reconstruction. This study was designed to look at the complication rates of 2 major hospitals in the United Kingdom. Methods: A large, 2-center retrospective cohort review of patients, who underwent implant-based breast reconstruction using Strattice (LifeCell Corp., Branchburg, N.J.) between March 2009 and November 2017, was performed. One-way analysis of variance was done to compare outcome significance between groups. Independent t test was performed to compare outcomes of 2 cohorts and regression analysis to include confounding factors using SPSS Statistics for Windows (Version 22.0. Armonk, NY: IBM Corp.). Results: A total of 450 and 400 breast reconstructions were carried out in University Hospital of South Manchester (UHSM) and Royal Free London Hospital (RFH), respectively. We recorded a total complication of 37.8% in RFH cohort and 28% in UHSM cohort. The seroma rate was 11.25% and 13.33% in the UHSM and RFH cohort, respectively. Other complications reported were major and minor infections, implant loss, skin necrosis, hematomas, and implant exposure. Multiple linear regression analysis reported that confounding factors affected certain outcomes. Conclusion: Our 2-center complication rates were comparable to other articles. Results were comparable despite being in 2 different breast units in the United Kingdom.