François Lescarbotte1*, Barbara Hersant1, Raphaëlle Billon1,2, Koohyar Habibi1, Oana Hermeziu1, Jean-Paul Meningaud1 and Romain Bosc1,2,3
1Department of Plastic, Reconstructive, Aesthetic and of Maxillofacial Surgery, Henri-Mondor University Hospital,
2Henri Mondor Breast Center, Paris-Est Créteil University, France
3Université Paris-Est Créteil, INSERM, France
Background: Chest wall reconstruction is required after full-thickness chest wall resection to preserve respiratory function and protect intra thoracic organs. Surgeons now have access to an array of synthetic and biologic prostheses that, together with soft-tissue coverage, restore chest wall integrity. The effectiveness of Acellular Dermal Matrices (ADM) in chest wall reconstruction has not been formally evaluated. To address this issue, we performed a systematic review of studies analyzing complication rates of ADM for chest wall reconstruction.
Materials and Methods: We performed a literature search in the MEDLINE and Cochrane databases from 2000 until June 2020 to identify studies that have analyzed the use of ADM alone. We then extracted relevant data’s from the studies that met the inclusion criteria.
Results: Out of an initial 116 published studies retrieved 20 studies involving 126 patients who underwent chest wall reconstruction with ADM matched our inclusion criteria and were included in the analysis. The total complication rate was 19.0%. The most common complications were local infections 7.1%, postoperative hematoma and seroma 5.5%, followed by few other complications including 2 wound breakdowns, 2 distal flap necrosis without ADM exposure, 2 pleural effusions, 2 postoperative pneumonias and 1 case of Cerebrospinal Fluid (CSF) leak due to dural tear.
Conclusion: ADM appears to be a safe option for reconstructing the chest wall. The array of new products on the market calls for evaluation of their effectiveness in prospective as well as costeffectiveness
Lescarbotte F, Hersant B, Billon R, Habibi K, Hermeziu O, Meningaud J-P, et al. The Use of Acellular Dermal Matrix for Chest Wall Reconstruction: A Systematic Review. Ann Plast Reconstr Surg. 2020;4(4):1064..