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Review
. 2016 Jan 21:5:Doc06.
doi: 10.3205/iprs000085. eCollection 2016.

Protocol for the prevention and management of complications related to ADM implant-based breast reconstructions

Isabelle Citron  1 , Rory Dower  1 , Mark Ho-Asjoe  1
Affiliations
Review

Protocol for the prevention and management of complications related to ADM implant-based breast reconstructions

Isabelle Citron et al. GMS Interdiscip Plast Reconstr Surg DGPW. .

Abstract
in English, German

Acellular dermal matrix (ADM) implant-based reconstructions have transformed direct-to-implant breast reconstruction (DTI). But like all surgery, it is not deplete of complications such as seroma, infections and wound healing problems. These are cited with varying frequencies in the literature. With increased experience and through a series of measures instituted to minimize complications, we have been able to improve outcomes for our patients. We report our technical refinements for prevention of ADM reconstruction associated complications including patient selection, implant selection, drains, dressing and our post operative antibiotic regime. We also outline our protocol for the management of ADM associated complications including seroma, simple and complex infection and red breast syndrome, such that the sequelae of complications are minimized and patients achieve a better long-term outcome.

Acelluläre Gewebematrix (ADM) wird routinemäßig bei implantatbasierten Brustrekonstruktionen verwendet. Wie bei allen operativen Eingriffen kann es zu Komplikationen wie z.B. Seromen, Infektionen und einer gestörten Wundheilung kommen. Die Häufigkeitsangaben in der Literatur sind sehr unterschiedlich. Mit zunehmender Erfahrung und einer Reihe von Maßnahmen zur Verringerung der Komplikationsraten konnten die Ergebnisse für unsere Patientinnen verbessert werden. Eine Prävention ADM-assoziierter Komplikationen beinhaltet die Auswahl geeigneter Patientinnen und Implantate, Drainagen und Wundverbände sowie das postoperative Antibiotika-Regime. Darüberhinaus stellen wir unser Protokoll zur Vorgehensweise bei ADM-assoziierten Komplikationen wie Seromen, einfachen und komplexen Infektionen und dem Syndrom der roten Brust vor, mit dem der Schweregrad verringert und die Langzeitergebnisse verbessert werden.

Keywords: Strattice; acellular dermis; breast reconstruction; complications; implant-based; learning curve.

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