Breast reconstruction with Alloderm Ready to Use: A meta-analysis of nine observational cohorts

Breast. 2018 Jun:39:89-96. doi: 10.1016/j.breast.2018.03.007. Epub 2018 Apr 6.

Abstract

Background: AlloDerm-RTU is a new member of human acellular dermal matrix (HADM) which was launched in 2012. The present meta-analysis aimed to investigate whether AlloDerm-RTU was superior compared with previous HADMs.

Methods: All available databases were searched for retrospective or prospective studies regarding breast reconstruction with AlloDerm-RTU compared with other HADMs. The primary outcome was the incidence of complications among different HADMs.

Results: Two prospective and seven retrospective studies with a total of 1406 patients were enrolled. There was no significant difference in any of the complications, including the incidence of hematoma (RR 0.78, 95%CI 0.19 to 3.19; P = 0.73), seroma (RR 0.98, 95%CI 0.43 to 2.26; P = 0.97), cellulitis (RR 0.82, 95%CI 0.32 to 2.11; P = 0.68), necrosis (RR 0.69, 95%CI 0.44 to 1.10; P = 0.12), infection (RR 0.68, 95%CI 0.37 to 1.25; P = 0.22), explantation (RR 0.61, 95%CI 0.35 to 1.06; P = 0.08), and total complications (RR 0.91, 95%CI 0.55 to 1.52; P = 0.73). Subgroup analysis showed that AlloDerm-RTU demonstrated no superiority compared with FD AlloDerm, AlloMax, or DermACELL. Sensitivity analysis indicated that the outcomes were stabilized. No publication bias existed in the present meta-analysis.

Conclusion: Four HADM products, AlloDerm-RTU, FD AlloDerm, AlloMax, and DermACELL, showed similar risks of complications. However since most of the included studies had a low level of evidence, further random trials with large numbers of patients are needed.

Keywords: Alloderm RTU; Allomax; Breast reconstruction; DermACELL; FD Alloderm; Meta-analysis.

Publication types

  • Meta-Analysis

MeSH terms

  • Breast Implants*
  • Breast Neoplasms / surgery*
  • Collagen / adverse effects
  • Collagen / therapeutic use*
  • Female
  • Hematoma / epidemiology
  • Hematoma / etiology
  • Humans
  • Mammaplasty / adverse effects
  • Mammaplasty / instrumentation*
  • Mammaplasty / methods
  • Middle Aged
  • Observational Studies as Topic
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prospective Studies
  • Retrospective Studies
  • Seroma / epidemiology
  • Seroma / etiology
  • Tissue Expansion Devices*
  • Treatment Outcome

Substances

  • AlloMax
  • Alloderm
  • Collagen