Lee, Jun Ho
(Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine)
,
Park, Ki Rin
(Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine)
,
Kim, Tae Gon
(Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine)
,
Ha, Ju-Ho
(Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine)
,
Chung, Kyu-Jin
(Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine)
,
Kim, Yong-Ha
(Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine)
,
Lee, Soo Jung
(Department of General Surgery, Yeungnam University College of Medicine)
,
Kang, Soo Hwan
(Department of General Surgery, Yeungnam University College of Medicine)
Background To date, various types of acellular dermal matrix (ADM) have been developed for clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breast reconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM that requires no drying process. Therefo...
Background To date, various types of acellular dermal matrix (ADM) have been developed for clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breast reconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM that requires no drying process. Therefore, theoretically, it has a higher degree of preservation of the dermal structures than AlloDerm. We conducted this study to compare the clinical course and postoperative outcomes of patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG CryoDerm. Methods We performed a retrospective analysis of the medical records in a consecutive series of 50 patients who underwent direct-to-implant breast reconstruction using AlloDerm (n=31) or CryoDerm (n=19). We then compared the clinical course and postoperative outcomes of the two groups based on the overall incidence of complications and the duration of drainage. Results The mean follow-up period was 16 months. There were no significant differences in the overall incidence of complications (seroma, infection, skin flap necrosis, capsular contracture, and implant loss) between the two groups. Nor was there any significant difference in the duration of drainage. Conclusions CG CryoDerm has the merits of short preparation time and easy handling during surgery. Our results indicate that CG CryoDerm might be an alternative allograft material to AlloDerm in direct-to-implant breast reconstruction.
Background To date, various types of acellular dermal matrix (ADM) have been developed for clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breast reconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM that requires no drying process. Therefore, theoretically, it has a higher degree of preservation of the dermal structures than AlloDerm. We conducted this study to compare the clinical course and postoperative outcomes of patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG CryoDerm. Methods We performed a retrospective analysis of the medical records in a consecutive series of 50 patients who underwent direct-to-implant breast reconstruction using AlloDerm (n=31) or CryoDerm (n=19). We then compared the clinical course and postoperative outcomes of the two groups based on the overall incidence of complications and the duration of drainage. Results The mean follow-up period was 16 months. There were no significant differences in the overall incidence of complications (seroma, infection, skin flap necrosis, capsular contracture, and implant loss) between the two groups. Nor was there any significant difference in the duration of drainage. Conclusions CG CryoDerm has the merits of short preparation time and easy handling during surgery. Our results indicate that CG CryoDerm might be an alternative allograft material to AlloDerm in direct-to-implant breast reconstruction.
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문제 정의
This is the first study to compare the clinical course and postoperative outcomes of patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG CryoDerm.
가설 설정
There are some limitations of the current study as follows: 1) We enrolled a small number of patients and they each had their own individual problems, which might be underpowered. 2) We failed to determine whether there were any differences in the graft compliance and the degree of incorporation or neovascularization between the two groups.
a)Breasts with more than one complication were counted once.
제안 방법
, Seongnam, Korea). All of the breast reconstructions were performed by a single plastic surgeon. We used AlloDerm during a period ranging from June of 2010 to May of 2012 and CG CryoDerm from October of 2011 to April of 2012.
We collected baseline data such as demographic information, the clinical course, and postoperative outcomes. All of the patients underwent direct-to-implant immediate breast reconstruction with one of the two types of ADM and Biocell textured silicone gel implants (Allergan Corp., Irvine, CA, USA). We divided our clinical series of patients into two groups: the AlloDerm group and the CG CryoDerm group.
데이터처리
, Chicago, IL, USA). To compare the patient characteristics (age, body mass index, implant size) and mean duration of drainage, we performed an independent t-test. We performed a chisquared test to compare the patient characteristics (adjuvant chemotherapy and skin incision) and Fisher’s exact test to compare the overall incidence of complications and breast cancer stage of the two groups.
성능/효과
There are some limitations of the current study as follows: 1) We enrolled a small number of patients and they each had their own individual problems, which might be underpowered. 2) We failed to determine whether there were any differences in the graft compliance and the degree of incorporation or neovascularization between the two groups. This is because we did not obtain tissue samples from the sites of the dermal graft for histologic examination in one-stage breast reconstruction.
To summarize, there were no significant differences in the overall incidence of complications or the duration of drainage between patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG Cryo-Derm. In conclusion, our results indicate that CG CryoDerm might be an alternative allograft material to AlloDerm in directto-implant breast reconstruction. CG CryoDerm has the merit of short preparation time and easy handling during surgery.
Our results showed that the use of AlloDerm and CG Cryo-Derm are both effective procedures, with a similar incidence of complications, in supporting the position of the implant in its original location and creating the inferior and lateral folds of the breast. Theoretically, the technique of preparation of CG CryoDerm should cause less destruction to the normal dermal tissue than that of Alloderm.
The drains were left in place until there was less than 20 mL of drainage over a 24-hour period, which could take 3 weeks. Though there were no significant differences among the two groups, the CG CryoDerm group had a tendency toward a higher infection rate than the AlloDerm group (Fig. 3). All infection cases were local infection or cellulitis, which was resolved through a course of either oral or intravenous antibiotics, except one case of the AlloDerm group.
참고문헌 (22)
1 Breuing KH Warren SM Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings Ann Plast Surg 2005 55 232 239 16106158
2 Spear SL Pelletiere SC Lockwood M Immediate breast reconstruction with tissue expanders and AlloDerm Spear SL Willey SC Robb GL Surgery of the breast: principles and art 2nd ed Philadelphia Lippincott Williams & Wilkins 2006 484 488
3 Salzberg CA Direct-to-implant breast reconstruction Clin Plast Surg 2012 39 119 126 22482353
6 Gabriel A Maxwell GP Evolving role of alloderm in breast surgery Plast Surg Nurs 2011 31 141 150 22157603
7 Basu CB Leong M Hicks MJ Acellular cadaveric dermis decreases the inflammatory response in capsule formation in reconstructive breast surgery Plast Reconstr Surg 2010 126 1842 1847 21124125
15 Taban M Douglas R Li T Efficacy of "thick" acellular human dermis (AlloDerm) for lower eyelid reconstruction: comparison with hard palate and thin AlloDerm grafts Arch Facial Plast Surg 2005 7 38 44 15655173
16 Kim HS Suh HW Ha KY The usefulness of the endonasal incisional approach for the treatment of nasal bone fracture Arch Plast Surg 2012 39 209 215 22783528
19 Lifecell Strattice reconstructive tissue matrix [Internet] Branchburg, NJ LifeCell Corp. 2013 cited 2013 Mar 8 Available from: http://www.lifecell.com/health-care-professionals/lifecell-products/stratticetm-reconstructive-tissue-matrix
20 Synthes DermaMatrix acellular dermis [Internet] Philadelphia Synthes Inc. 2012 cited 2013 Mar 8 Available from: http://www.synthes.com/sites/NA/Products/CMF/AcellularDermis/Pages/DermaMatrix_Acellular_Dermis.aspx
21 Ethicon Inc FlexHD acellular hydrated dermis for breast reconstruction [Internet] New Jersey Ethicon Inc. 2013 cited 2013 Mar 8 Available from: http://www.ethicon360.com/products/flex-hd-acel-hydrated-dermis-breast-reconstruction
22 Covidien Permacol surgical implant [Internet] Mansfield Covidien 2013 cited 2013 Mar 8 Available from: http://www.autosuture.com/autosuture/pagebuilder.aspx?webPageID=0&topicID=170603&xsl=xsl/productPagePrint.xsl
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