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Letter to the Editor
Letter to the Editor
Plastic Surgery International
Volume 2017, Article ID 1283735, 9 pages
Research Article

Evaluation of Complication Rates after Breast Surgery Using Acellular Dermal Matrix: Median Follow-Up of Three Years

1Department of Plastic, Aesthetic, Reconstructive and Hand Surgery, Agaplesion Diakonieklinikum Rotenburg, Elise-Averdieck-Straße 17, 27356 Rotenburg (Wümme), Germany
2Harvard Medical School, Brigham and Women’s Hospital, Department of Surgery, Division of Plastic Surgery, 75 Francis Street, Boston, MA 02115, USA
3Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Alfried Krupp Krankenhaus, Hellweg 100, 45276 Essen, Germany
4Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neubergstraße 1, 30625 Hannover, Germany
5Department of Pathology, Agaplesion Diakonieklinikum Rotenburg, Elise-Averdieck-Straße 17, 27356 Rotenburg, Germany
6Department of Surgery, Royal Brompton Hospital, Sydney St, London, UK
7Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany

Correspondence should be addressed to Felix J. Paprottka; moc.em@akttorpap.xilef

Received 13 January 2017; Accepted 11 May 2017; Published 12 June 2017

Academic Editor: Nicolò Scuderi

Copyright © 2017 Felix J. Paprottka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Acellular dermal matrices (ADMs) are now commonly used for breast reconstruction surgery. There are various products available: ADMs derived from human (HADM), porcine (PADM), or bovine (BADM) sources. Detailed long-term follow-up studies are necessary to detect differences in complication rates between these products. Material and Methods. From 2010 to 2015, forty-one patients underwent 52 ADM-breast reconstructions in our clinic, including oncologic breast reconstructions and breast augmentation revisions (). 15x HADMs (Epiflex®/DIZG), 21x PADMs (Strattice®/LifeCell), and 16x BADMs (Tutomesh®/RTI Surgical) were implanted. Retrospective data collection with median follow-up of 36 months (range: 12–54 months) was performed. Results. Overall complication rate was 17% after ADM implantation (HADM: 7%; PADM: 14%; BADM: 31%). In a composite endpoint of complications and Red Breast Syndrome, a lower event probability was observed between BADMs, PADMs, and HADMs (44%, 19%, and 7%, resp.; for the trend). Furthermore, capsular contracture occurred in 6%, more frequently as compared to the current literature. Conclusions. When ADM-based reconstruction is indicated, the authors suggest primarily the use of HADMs and secondary the use of PADMs. It is shown that BADMs have the highest complication probability within our patient cohort; nevertheless, BADMs convey physical advantages in terms of flexibility and better aesthetic outcomes. The indication for the use of ADMs should be filled for each case individually.