Sbitany Hani, Mukhatyar Vivek, Hammer Jason, Hoonjan Amardeep, Leung Braden K, Gardocki-Sandor Maryellen
From the Division of Plastic and Reconstructive Surgery, Mount Sinai Medical Center, New York, NY.
Allergan Aesthetics, an AbbVie Company, Branchburg, NJ.
Plast Reconstr Surg Glob Open. 2025 Apr 2;13(4):e6671. doi: 10.1097/GOX.0000000000006671. eCollection 2025 Apr.
Acellular dermal matrices (ADMs) are biologic meshes commonly used in implant-based breast reconstruction (IBBR) procedures to provide implant support and coverage. Although the etiology is not well understood, increasing preclinical and clinical evidence suggest that ADMs may help prevent capsular contracture, a frequent complication of IBBR, by modulating the inflammatory response in the tissue surrounding breast implants. The objective of this narrative review is to discuss the evidence supporting the role of inflammation in capsular contracture following IBBR without ADM, and to characterize the potential mechanism(s) by which ADMs may reduce the incidence of capsular contracture in IBBR.
Relevant studies in English published up to December 31, 2023, were identified from 4 databases (BIOSIS Previews, Embase, MEDLINE, and Northern Light Life Sciences Conference Abstracts) using search terms such as "breast" and "capsular contracture."
This review discusses the potential factors (eg, expander-to-implant reconstruction, diminished collagen integrity, postmastectomy radiation therapy, surface of implant, plane of placement, incision type, hematoma, seroma, postoperative infection, and biofilm) and emerging biomarkers (eg, , , TIMP-1, TIMP-2, , MMP2, , , , , and hyaluronan) that may be able to predict capsular contracture. The available evidence that tissue integration of ADMs modulates the wound healing process and inflammation, and the available clinical evidence, which indicates that ADMs may decrease rates of capsular contracture following postmastectomy radiation therapy, are summarized.
The studies summarized in this review suggest that ADMs may reduce the likelihood of capsular contracture in IBRR compared with no ADM use.
脱细胞真皮基质（ADM）是生物网片，常用于基于植入物的乳房重建（IBBR）手术中，以提供植入物支撑和覆盖。尽管其病因尚未完全明确，但越来越多的临床前和临床证据表明，ADM可能通过调节乳房植入物周围组织的炎症反应来帮助预防包膜挛缩，这是IBBR常见的并发症。本叙述性综述的目的是讨论支持炎症在无ADM的IBBR后包膜挛缩中作用的证据，并描述ADM可能降低IBBR中包膜挛缩发生率的潜在机制。
使用“乳房”和“包膜挛缩”等检索词，从4个数据库（BIOSIS Previews、Embase、MEDLINE和Northern Light Life Sciences Conference Abstracts）中检索截至2023年12月31日发表的英文相关研究。
本综述讨论了可能能够预测包膜挛缩的潜在因素（如扩张器到植入物重建、胶原蛋白完整性降低、乳房切除术后放疗、植入物表面、放置平面、切口类型、血肿、血清肿、术后感染和生物膜）和新兴生物标志物（如 、 、TIMP-1、TIMP-2、 、MMP2、 、 、 、 和透明质酸）。总结了ADM组织整合调节伤口愈合过程和炎症的现有证据，以及表明ADM可能降低乳房切除术后放疗后包膜挛缩发生率的现有临床证据。
本综述总结的研究表明，与不使用ADM相比，ADM可能降低IBRR中包膜挛缩的可能性。
