Use of Fetal Bovine Acellular Dermal Xenograft With Tissue Expansion for Staged Breast Reconstruction

Introduction: Staged breast reconstruction with implants and human acellular cadaveric dermis offers advantages of precise expander positioning, higher initial expander fill volumes, and improved outcomes. This study reports breast reconstruction using fetal bovine acellular dermal matrix (FBADM). The high type III collagen content of FBADM may allow for more rapid tissue incorporation and healing. Methods: A total of 49 breast reconstructions in 28 patients (group A) with FBADM were retrospectively compared with 123 reconstructions in 91 patients operated without FBADM (group B). Results: FBADM sizes ranged from 48 to 100 cm(2) (mean size: 70.6 cm(2)). The mean immediate fill volume in group A was 181.2 +/- 148.3 mL and 117.7 +/- 66.3 mL in group B (P < 0.001). The duration of drainage was significantly shorter in group A (8.51 +/- 3.4 days) as compared with controls (11.07 +/- 5.1 days), t-test (P = 0.015). There was no significant difference in the overall complication rate (20.8% in group A, 13.0% in group B). Further subgroup analysis of group A patients with complications and without complications, showed that group with complications had significantly longer drain removal time (9.48 vs. 7.97 days), larger initial fill volumes (238.1 vs. 145.3 mL), and a higher BMI (25.8 vs. 22.6 kg/m(2)) when compared with the complication-free subgroup. Conclusions: The use of FBADM in breast reconstruction offers results comparable with that of human acellular dermal matrix as reported in the literature. However, FBADM significantly reduced wound drainage time in our study when compared with patients without FBADM.