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. 2015 May;42(3):321-6.
doi: 10.5999/aps.2015.42.3.321. Epub 2015 May 14.

Daily serum collection after acellular dermal matrix-assisted breast reconstruction

Glenda Giorgia Caputo  1 , Zeno Franchini  2 , Monia Maritan  1 , Edoardo Dalla Pozza  1 , Enrico Vigato  1 , Umberto Tedeschi  2 , Maurizio Governa  1
Affiliations

Daily serum collection after acellular dermal matrix-assisted breast reconstruction

Glenda Giorgia Caputo et al. Arch Plast Surg. 2015 May.

Abstract

Background: The acellular dermal matrix (ADM)-assisted breast reconstruction technique is widely known, but discouraging results due to early postoperative complications have been reported. As the literature identifies seroma as the most common issue after breast surgery without identifying its pathogenesis, we aimed to report the trend of postoperative daily serum collection after ADM-assisted breast reconstruction and compare it with data in the literature in order to discover more about this little-known topic.

Methods: A retrospective study on 28 consecutive patients who received ADM-assisted breast reconstruction between February 2013 and February 2014 was performed. In order to reduce the number of variables that could affect serum production, only one brand of ADM was used and all tissues were handled gently and precisely. The daily drainage volume was recorded per patient during the first four days of hospitalization. Likewise, postoperative complications were noted during routine follow-up.

Results: In total, five (17.9%) bilateral and 23 (82.1%) unilateral ADM-assisted breast reconstructions (33 implants) were performed. The mean age, body mass index, and length of hospital stay were 53.6 years, 21.3 kg/m(2), and 4.5 days, respectively. One major complication led to implant loss (3.0%), and nine minor complications were successfully treated with ambulatory surgery (27.3%). Serum collection linearly decreased after 24 hours postoperatively.

Conclusions: Daily drainage decreased following the theoretical decline of acute inflammation. In concordance with the literature, daily serum production may not be related to the use of ADM.

Keywords: Acellular dermis; Inflammation; Mammaplasty; Mastectomy; Seroma.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Postoperative daily serum collection
The average volume of serum collected daily from the acellular dermal matrix-submuscular pocket (drain 1) and the subcutaneous position (drain 2) during the first 4 days postoperatively.
Fig. 2
Fig. 2. Aesthetic outcomes
Results of a skin-sparing mastectomy with an acellular dermal matrix-assisted reconstruction on the left breast. Preoperative pictures in the lateral and frontal views (A-C) with the foreground of the original ptosis of the left breast (D) and postoperative lateral and frontal pictures at 30 days (E-G) are shown. Postoperatively, preservation of the natural ptosis was achieved (H).
Fig. 3
Fig. 3. Capsular histological samples 2 months postoperatively
The microscopic view demonstrates complete incorporation of the matrix with large cell and microvascular ingrowth (H&E, ×100).
See this image and copyright information in PMC

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