Glynou, Sevasti Panagiota;
Sousi, Sara;
Cook, Hannah;
Zargaran, Alexander;
Zargaran, David;
Mosahebi, Afshin;
(2024)
A comparison of acellular dermal matrices (ADM) efficacy and complication profile in women undergoing implant-based breast reconstruction: a systematic review and network meta-analysis.
BMC Cancer
, 24
, Article 1598. 10.1186/s12885-024-13359-3.
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Abstract
INTRODUCTION: Breast cancer is the leading cause of cancer amongst women in the United Kingdom, with implant-based reconstruction (IBR) using Acellular Dermal Matrices (ADM) gaining popularity for post-mastectomy procedures. This study compares outcomes of different ADMs that are commonly used in women undergoing IBR, this was short and long-term complications. METHODS: A systematic search of MEDLINE, Embase, CENTRAL, and CDSR databases was performed according to the PRISMA guidelines, focusing on women undergoing IBR with FlexHD, AlloDerm, Bovine, or Porcine ADMs. A network meta-analysis (NMA) was also conducted. RESULTS: A total of 51 studies were captured by the search, of which 27 were included in the network meta-analysis. Alloderm was the most used ADM (54%), followed by Porcine (17%), Bovine (11%), DermAcell (11%), and FlexHD (7%). The mean follow-up was 27.8 months. The complication rates varied. Porcine ADMs had the highest rate of seroma formation (10.3%) and of haematoma formation (2.7%). AlloDerm FD had the highest rate of wound dehiscence (3.1%). Implant failure was highest in AlloDerm FD ADMs (11.8%), followed by Porcine ADMs (11.2%). Infections were most common in Porcine (11.2%) and AlloDerm FD ADMs (11.0%). Capsular contracture was rare across all ADM types, with no significant differences observed. In the NMA, AlloDerm FD showed significantly higher risks of infection, explantation, and wound dehiscence compared to AlloDerm RTU. CONCLUSION: The overall complication profiles of ADMs used in IBR are similar, except for the higher risks associated with AlloDerm FD compared to RTU. These findings suggest that the choice of ADM may not significantly impact overall outcomes, except in specific cases like AlloDerm FD. Further high-quality, long-term, double-arm studies are necessary to confirm comparative profile of specific ADM types and to account for potential confounding variables through multivariable regression analysis.
| Type: | Article |
|---|---|
| Title: | A comparison of acellular dermal matrices (ADM) efficacy and complication profile in women undergoing implant-based breast reconstruction: a systematic review and network meta-analysis |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12885-024-13359-3 |
| Publisher version: | https://doi.org/10.1186/s12885-024-13359-3 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Breast surgery, Reconstructive breast surgery, Acellular dermal matrix, ADM |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10205966 |
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