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脱细胞真皮基质(SimpliDerm和即用型AlloDerm)在即刻乳房重建中的临床结果。

Clinical Outcomes of Acellular Dermal Matrix (SimpliDerm and AlloDerm Ready-to-Use) in Immediate Breast Reconstruction.

作者信息

Tierney Brian P, De La Garza Mauricio, Jennings George R, Weinfeld Adam B

机构信息

Plastic Surgery, Tierney Plastic and Reconstructive Surgery, Nashville, USA.

Plastic and Reconstructive Surgery, DHR Health, McAllen, USA.

出版信息

Cureus. 2022 Feb 18;14(2):e22371. doi: 10.7759/cureus.22371. eCollection 2022 Feb.

Abstract

Background The use of acellular dermal matrix (ADM) for post-mastectomy reconstruction is considered by many surgeons to be an accepted component of surgical technique. Early clinical experience is described for SimpliDerm® - a novel human ADM (Aziyo Biologics, Silver Spring, USA), and AlloDerm® Ready-To-Use (RTU) - an established ADM (Allergan Medical, Irvine, USA). Methods Records were retrospectively reviewed from four sites between 2016 and 2021 of patients who underwent immediate, two-stage reconstruction with either SimpliDerm (n=38) or AlloDerm RTU (n=69) after mastectomy and were followed out to exchange to permanent implant(s), tissue expander(s) explant, or death. Results Immediate breast reconstruction with tissue expanders and ADM was performed on 107 patients (181 breasts). Overall mean patient age was 51.4 ± 12.4 years, and mean BMI was 28.0 ± 5.8 kg/m. Significantly more patients in the SimpliDerm group were of Hispanic or Latino ethnicity (34.2% vs. 7.2%; P<.001). Reconstructions were predominantly prepectoral (82.3%). A total of 35 adverse events (AEs) occurred in 27 (25.2%) patients, with no difference in AE type, classification, or rates between ADM groups. No AEs were considered related to either ADM. The observed AE profiles and rates are similar to those published for other ADMs in immediate breast reconstruction. Conclusions There continues to be a need for additional clinically equivalent ADMs to provide physicians with more availability and options for their practice. This retrospective, multisite study describes comparable clinical outcomes with SimpliDerm and AlloDerm RTU through a median of 133.5 days (~four months) following immediate two-stage breast reconstruction.

摘要

背景 许多外科医生认为,使用脱细胞真皮基质(ADM)进行乳房切除术后重建是手术技术中被认可的一部分。本文描述了SimpliDerm®(一种新型人源ADM,美国银泉市Aziyo生物制品公司生产)和AlloDerm®即用型(RTU,一种已获认可的ADM,美国尔湾市艾尔建医疗公司生产)的早期临床经验。方法 回顾性分析了2016年至2021年期间四个机构的记录,这些患者在乳房切除术后接受了即刻两阶段重建,使用SimpliDerm(n = 38)或AlloDerm RTU(n = 69),并随访至更换为永久性植入物、取出组织扩张器或死亡。结果 107例患者(181侧乳房)接受了使用组织扩张器和ADM的即刻乳房重建。患者总体平均年龄为51.4±12.4岁,平均BMI为28.0±5.8kg/m²。SimpliDerm组中西班牙裔或拉丁裔患者明显更多(34.2%对7.2%;P<0.001)。重建主要在胸肌前进行(82.3%)。27例(25.2%)患者共发生35起不良事件(AE),ADM组之间在AE类型、分类或发生率方面无差异。没有AE被认为与任何一种ADM相关。观察到的AE情况和发生率与其他ADM用于即刻乳房重建时所发表的相似。结论 仍然需要更多临床上等效的ADM,以便为医生在实践中提供更多的可及性和选择。这项回顾性多机构研究描述了在即刻两阶段乳房重建后,通过中位133.5天(约四个月)随访,SimpliDerm和AlloDerm RTU具有可比的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53fa/8856737/7928217eb64a/cureus-0014-00000022371-i01.jpg

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