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Acellular Dermal Matrix

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Laura J Esserman – One of the best experts on this subject based on the ideXlab platform.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    BACKGROUND: Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. METHODS: Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. RESULTS: The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. CONCLUSIONS: Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    Background Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. Methods Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. Results The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. Conclusions Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. Clinical question/level of evidence Therapeutic, III.

Anne Warren Peled – One of the best experts on this subject based on the ideXlab platform.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    BACKGROUND: Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. METHODS: Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. RESULTS: The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. CONCLUSIONS: Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    Background Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. Methods Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. Results The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. Conclusions Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. Clinical question/level of evidence Therapeutic, III.

Shelley E Hwang – One of the best experts on this subject based on the ideXlab platform.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    BACKGROUND: Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. METHODS: Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. RESULTS: The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. CONCLUSIONS: Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    Background Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. Methods Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. Results The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. Conclusions Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. Clinical question/level of evidence Therapeutic, III.

Michael Alvarado – One of the best experts on this subject based on the ideXlab platform.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    BACKGROUND: Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. METHODS: Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. RESULTS: The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. CONCLUSIONS: Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    Background Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. Methods Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. Results The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. Conclusions Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. Clinical question/level of evidence Therapeutic, III.

Cheryl Ewing – One of the best experts on this subject based on the ideXlab platform.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    BACKGROUND: Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. METHODS: Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. RESULTS: The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. CONCLUSIONS: Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

  • the effects of Acellular Dermal Matrix in expander implant breast reconstruction after total skin sparing mastectomy results of a prospective practice improvement study
    Plastic and Reconstructive Surgery, 2012
    Co-Authors: Anne Warren Peled, Robert D Foster, Elisabeth R Garwood, Dan H Moore, Cheryl Ewing, Michael Alvarado, Shelley E Hwang, Laura J Esserman
    Abstract:

    Background Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using Acellular Dermal Matrix nor a strategy for optimal Acellular Dermal Matrix selection criteria has been well described. Methods Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no Acellular Dermal Matrix) comprised 90 cases in which Acellular Dermal Matrix was not used. Cohort 2 (consecutive Acellular Dermal Matrix) included the next 100 consecutive cases, which all received Acellular Dermal Matrix. Cohort 3 (selective Acellular Dermal Matrix) consisted of the next 260 cases, in which Acellular Dermal Matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis. Results The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no-Acellular Dermal Matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of Acellular Dermal Matrix in irradiated patients. Conclusions Acellular Dermal Matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy. Clinical question/level of evidence Therapeutic, III.