Identifying risk factors for postoperative major complications in staged implant-based breast reconstruction with AlloDerm.
Acellular dermal matrices (ADM) have reportedly been associated with postoperative complications following breast reconstruction. The purpose of this study was to identify risk factors predictive of major postoperative complications after staged implant-based breast reconstruction with ADM. A retrospective study of all patients who underwent implant-based breast reconstruction with AlloDerm between 2013 and 2017 was conducted. Demographic information, procedural data, and postoperative complications were retrieved. The main objective was to analyze patient and procedural factors associated with the occurrence of major complications, including postoperative readmission and loss of reconstruction. A total of 166 patients (288 breasts) were included. Major complications were noted in 19.9%. The overall rate of infection and mastectomy skin necrosis was 16.9% and 6.6%, respectively. Readmission occurred in 16.3% and loss of reconstruction occurred in 8.4% of patients. Risk factors for major complications included body mass index (BMI) >27.0 kg/m2 (OR 2.46; p = 0.041), higher tissue expander volume (p = 0.049), history of chemotherapy (OR 2.20; p = 0.047) and radiotherapy (OR 2.22; p = 0.040). Loss of reconstruction was associated with a BMI >27.0 kg/m2 (OR 4.00; p = 0.012), tobacco use (OR 6.64, p = 0.006), and higher tissue expander volume (p = 0.035). Similarly, readmission was associated with higher tissue expander volume (p = 0.042). In conclusion, a variety of factors were identified to be associated with major complications, including higher BMI, increased tissue expander volume, as well as history of chemotherapy and radiation. This information is valuable for pre-operative counseling and for future comparative studies between different ADM types.
['Remington|Austin C|AC|', 'Gurtner|Geoffrey C|GC|', 'Wan|Derrick C|DC|', 'Nguyen|Dung|D|', 'Momeni|Arash|A|0000-0002-6452-751X']
D000328:Adult D015992:Body Mass Index D019928:Breast Implantation D018427:Breast Implants D001943:Breast Neoplasms D015331:Cohort Studies D003094:Collagen D005260:Female D006801:Humans D016462:Mammaplasty D008875:Middle Aged D010359:Patient Readmission D011183:Postoperative Complications D012189:Retrospective Studies D015625:Tissue Expansion Devices
Breast reconstruction Tissue Expander Acellular dermal matrix Breast implant Plastic surgery