How is the acellular dermis prepared for breast reconstruction?

Updated: Jul 29, 2021
  • Author: John Y S Kim, MD, FACS; Chief Editor: James Neal Long, MD, FACS  more...
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Answer

Answer

Once the assessment of skin excess and flap thickness is made intraoperatively and the decision is made to use ADM, the matrix should be prepared. If the acellular dermis is prehydrated, it can be rinsed in antibiotic solution; if it is freeze-dried, the hydration sequence can be initiated as indicated by the manufacturer.

A single-surgeon cohort study by Hagarty et al indicated that in implant-based breast reconstruction employing ADM, the use of meshed ADM, as opposed to the unmeshed variety, reduces overall complication rates, postoperative drain time (by 7.3 days), length of hospital stay, and postoperative need for parenteral narcotic administration (by 77%). [32]


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