A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction.

摘要: Background Multiple outcome studies have been published on the use of acellular dermal matrix (ADM) in breast reconstruction with disparate results. The purpose this study was to conduct a systematic review and meta-analysis determine an aggregate estimate risks associated ADM-assisted reconstruction. Methods MEDLINE, Web Science, Cochrane Library databases were queried, relevant articles up September 2010 analyzed based specific inclusion criteria. Seven complications studied including seroma, cellulitis, infection, hematoma, skin flap necrosis, capsular contracture, reconstructive failure. A pooled random effects for each complication 95% confidence intervals (CI) derived. For comparisons ADM non-ADM, odds ratio (OR) CI Heterogeneity measured using I2 statistic. Results Sixteen met rates seroma (6.9%; CI, 5.3%-8.8%), cellulitis (2.0%; 1.2%-3.1%), infection (5.7%; 4.3%-7.3%), necrosis (10.9%; 8.7%-13.5%), hematoma (1.3%; 0.6%-2.4%), contracture (0.6%; 0.1%-1.7%), failure (5.1%; 3.8%-6.7%). Five reported findings both non-ADM patients used calculate OR. reconstructions had higher likelihood (pooled OR, 3.9; 2.4-6.2), 2.7; 1.1-6.4), 3.0; 1.3-6.8) than without ADM. relation 2.0; 0.8-5.2), 0.9-4.3), 1.9; 0.6-5.4) inconclusive. Conclusions In evaluated, exhibited prosthetic-based traditional musculofascial flaps. is lower rate contracture. careful risk/benefit analysis should be performed when choosing implant-based