Comparing Complications in Acellular Dermal Matrices Used in Implant-Based Breast Reconstruction

A comparison of acellular dermal matrices (ADM) efficacy and complication profile in women undergoing implant-based breast reconstruction: a systematic review and network meta-analysis

Breast cancer remains the most common cancer among women in the United Kingdom, with implant-based reconstruction (IBR) increasingly utilised following mastectomy. A key component of many IBR procedures is the use of Acellular Dermal Matrices (ADMs), which provide structural support and promote healing. A recent study has examined the short- and long-term complication rates associated with the most commonly used ADMs, offering new insights into their comparative safety and performance.

Study Overview

A systematic review and network meta-analysis (NMA) were conducted following PRISMA guidelines. The analysis focused on women undergoing IBR with five types of ADM: AlloDerm, FlexHD, and DermACELL (human-derived), as well as Porcine and Bovine-derived products.

Four major medical databases were searched—MEDLINE, Embase, CENTRAL, and the Cochrane Database of Systematic Reviews (CDSR)—yielding 51 studies in total, of which 27 met the criteria for inclusion in the NMA.

Conclusion

While the overall complication profiles of the various ADMs used in implant-based breast reconstruction appear broadly similar, AlloDerm FD demonstrated a notably higher risk in several key complication categories compared to its ready-to-use counterpart.

These findings highlight the importance of ADM selection in post-mastectomy reconstruction, especially in cases where patients may already be at higher risk of complications. The authors stress the need for further high-quality, long-term comparative studies using multivariable regression analysis to better understand the potential impact of confounding variables and to refine ADM selection in clinical practice.

Read full meta-analysis here: A comparison of acellular dermal matrices (ADM) efficacy and complication profile in women undergoing implant-based breast reconstruction