Application of Newly Developed Acellular Dermal Matrix Allograft (CG DermTM) in Breast Reconstruction with the Implant: The Prospective Study

Several freeze-dried human acellular dermal matrix have been introduced and they helped to facilitate implant based breast reconstruction by providing support to the breast lower pole, firm fixation of inframammary fold, and simple operation procedure. We evaluated clinical outcomes of recently produced human acellular dermal matrix, CG Derm(TM), prospectively. CG Derm(TM) was used in six patients and eight breasts for implant breast reconstruction. Complete blood cell count test, rountine chemisty(including ESR) test, and CRP test were performed before and after the surgery. Postoperative complication was evaluated including infection, seroma, implant malpostion, rippling deformity, and capsular contracture. Randomly selected two patients underwent breast MRI after reconstruction. Finally we examine patients' satisfaction survey and plastic surgeons' evaluation. Satisfactory breast lower pole fullness, symmetric inframammary folds and breast shapes were achieved in most patients. Overall, patients had sufficient aesthetic satisfaction and surgeon's evaluation was also good. There was no major complication except four cases of seroma which healed with conservative management. Implant breast reconstruction using CG Derm(TM) was safe and obtain good aesthetic results. But further and larger scale study should be performed to reveal out the relatively high risk of seroma.

Implant Breast Reconstruction Using Porcine Dermal Matrix(Permacol(R)): A Comparative Study with Acellular Cadaveric Dermis(AlloDerm(R))

PURPOSE: The use of tissue expander/implant in breast reconstruction using tissue expander-implant is one of the most common surgical procedures. The use of AlloDerm as a sling to reestablish the lower pole of the pectoralis major muscle results a decrease in morbidity compared with more invasive procedures. However the use of AlloDerm is more expensive than other options. We decided to compare AlloDerm with Permacol, which has been safely used in human body reconstruction and is less costly than AlloDerm. METHODS: After mastectomy, the inferolateral origin of the pectoralis major muscle was elevated. Either AlloDerm or Permacol was sutured to the chest wall at the level of the previously marked inframammary fold. The lower border of the pectoralis major muscle and the upper portion of the crescent-shaped piece of either AlloDerm or Permacol was sutured together using a tension free technique, and a tissue expander was subsequently inserted into the subpectoral-subAlloDerm (or Permacol) dual pocket. RESULTS: AlloDerm was used in twenty-one patients(28 breasts) and Permacol was used in six patients(11 breasts) for tissue expander-implant breast reconstruction. During the mean follow-up period of 17 months(8~25 months). Two infections(7%) occurred in AlloDerm cases and four infections(36%) occurred in Permacol cases. CONCLUSION: This study is the first comparison of tissue expander/implant breast reconstruction using AlloDerm and Permacol. The use of Permacol resulted in more postoperative infection compared with the use of AlloDerm. This report is still limited with the small number of cases studied.