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Human acellular dermis increases surgical site infection and overall complication profile when compared with submuscular breast reconstruction: An updated meta-analysis incorporating new products
Human acellular dermal matrix (HADM) is an increasingly used adjunct to breast reconstruction. Previous meta-analyses demonstrate increased risks of complications, but these studies largely represent one product. The purpose of this study is to stratify outcomes on the basis of a meta-analysis of co...
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Published in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2018-11, Vol.71 (11), p.1547-1556 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Human acellular dermal matrix (HADM) is an increasingly used adjunct to breast reconstruction. Previous meta-analyses demonstrate increased risks of complications, but these studies largely represent one product. The purpose of this study is to stratify outcomes on the basis of a meta-analysis of complications incorporating all new studies after 2012 and their associated new human-based products.
A query of the MEDLINE database for articles on HADM and breast reconstruction from January 2012 to October 2015 yielded 172 citations. Two levels of screening identified 47 relevant studies. Thirteen studies were used in comparative meta-analysis.
Complication rates were higher in HADM patients: total complications, 17.7% versus 6.1%; seroma, 8.3% versus 5.4%; infection, 7.2% versus 5.9%; and flap necrosis, 14.7% versus 7.1%. Meta-analysis revealed a statistically significant increased risk of total complications in patients who underwent reconstruction with HADM when compared with their submuscular reconstruction cohort (p = 0.03; relative risk (RR) = 1.46; confidence interval (CI): 1.04–2.04). Patients who underwent reconstruction with HADM demonstrated a significantly increased risk of flap necrosis (p |
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ISSN: | 1748-6815 1878-0539 |
DOI: | 10.1016/j.bjps.2018.06.012 |