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European Journal of Plastic Surgery
Published in: European Journal of Plastic Surgery 4/2018

Open Access 01-08-2018 | Original Paper

Is single-stage implant-based breast reconstruction (SSBR) with an acellular matrix safe?

Strattice™ or Meso Biomatrix® in SSBR

Authors: Nadine S. Hillberg, Patrick I. Ferdinandus, Rieky E. G. Dikmans, Bjorn Winkens, Juliette Hommes, René R. W. J. van der Hulst

Published in: European Journal of Plastic Surgery | Issue 4/2018

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Abstract

Background

Acellular matrices (AM) might enable a direct single-stage breast reconstruction procedure resulting in an improved efficacy of the reconstruction phase for patients. Safety concerns are an important issue due to a recent study which shows that single-stage breast reconstruction with Strattice™ resulted in more complications versus a two-stage reconstruction. Therefore, the goal of this study is to compare the short- and long-term complications of a single-stage breast reconstruction with the use of two types of AM (Strattice™ and Meso Biomatrix®) versus two-stage breast reconstruction without the use of an AM.

Methods

Cohort study with single-stage breast reconstruction with Strattice™ (n = 28) or Meso BioMatrix® (n = 20) or two-stage breast reconstruction without an AM (n = 36) at the Maastricht Academic Hospital, the Netherlands. All complications, in particular major complications with the need for re-admission to the hospital, re-exploration, and implant explantation, were the primary outcome measures. A 1-year follow-up was achieved for all patients.

Results

Baseline characteristics of all 52 patients were similar between groups. There was a significantly higher complication rate in the single-stage AM groups with loss of the implant in 40.0% of the breasts from the Meso BioMatrix® group and in 10.7% of the Strattice™ group compared to no implant loss in the control group.

Conclusions

This cohort study clearly suggests that the use of a single-stage breast reconstruction is not safe with the use of these AMs. Well-designed prospective studies that guarantee the safety of those matrices should be published before these AMs are used in implant-based surgery.
Level of Evidence: Level III, risk / prognostic study.
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Metadata
Title
Is single-stage implant-based breast reconstruction (SSBR) with an acellular matrix safe?
Strattice™ or Meso Biomatrix® in SSBR
Authors
Nadine S. Hillberg
Patrick I. Ferdinandus
Rieky E. G. Dikmans
Bjorn Winkens
Juliette Hommes
René R. W. J. van der Hulst
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 4/2018
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-018-1415-2

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