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A Meta-analysis Assessing Postsurgical Outcomes between Aseptic and Sterile AlloDerm Regenerative Tissue Matrix.

Macarios D, Griffin L, Chatterjee A, Lee LJ, Milburn C, Nahabedian MY - Plast Reconstr Surg Glob Open (2015)

Bottom Line: Included studies compared both RTU and FD.Results remained nonsignificant even after adjustment for variable follow-up time.The results suggest that there are no differences in complication rates between RTU and FD forms.

View Article: PubMed Central - PubMed

Affiliation: LifeCell, an Acelity Company, Bridgewater, N.J.; Acelity, San Antonio, Tex.; Divisions of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania Hospital, Philadelphia, Pa.; and Department of Plastic Surgery, Georgetown University, Washington, D.C.

ABSTRACT

Background: AlloDerm, a human acellular dermal matrix, is available in a ready-to-use (RTU) or freeze-dried (FD) form. A limited number of studies have compared complication rates between RTU and FD in implant-based breast reconstruction. The objective of this report was to conduct a meta-analysis of previously reported complication rates between RTU and FD.

Methods: A systematic literature review was conducted from 2010 to 2014 and supplemented by hand searches. Included studies compared both RTU and FD. Odds ratios and relative risks (RRs) with 95% confidence interval (CI), taking into account study heterogeneity, were calculated. Studies reporting patient-level results as opposed to breast-level results were excluded from the primary analysis but included in subsequent sensitivity analyses. Variable follow-up time within and between studies was also considered in a sensitivity analysis.

Results: Of the 275 identified studies, 115 studies were eligible for detailed review. Only 5 studies compared RTU with FD, and of these, 2 studies had breast-level data and 1 study had patient-level data appropriate for meta-analysis. The 2 studies included in the primary meta-analysis had a pooled sample size: n = 116 RTU and n = 109 FD patients, or 205 and 186 breasts, respectively. Age and body mass index were similar between groups. Across all meta-analyses, there were no differences in complication rates between RTU and FD: cellulitis (RR = 0.863; 95% CI, 0.272-2.740), seroma (RR = 0.553; 95% CI, 0.026-11.830), and explantation (RR = 0.593; 95% CI, 0.247-1.425). Results remained nonsignificant even after adjustment for variable follow-up time.

Conclusion: The results suggest that there are no differences in complication rates between RTU and FD forms.

No MeSH data available.


Related in: MedlinePlus

Prisma flow diagram. A total of 275 records were identified through literature searches. The majority of articles (n = 160) did not identify the sterile product explicitly. Of the remaining, 103 did not have comparative data or were duplicates, leaving 5 studies for qualitative synthesis and 3 for meta-analysis.
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Figure 1: Prisma flow diagram. A total of 275 records were identified through literature searches. The majority of articles (n = 160) did not identify the sterile product explicitly. Of the remaining, 103 did not have comparative data or were duplicates, leaving 5 studies for qualitative synthesis and 3 for meta-analysis.

Mentions: A total of 235 unique citations were retrieved and an additional 40 articles were found by manually searching the aforementioned plastic surgery journals. From the 275 identified citations, 115 were eligible for full review to determine which type of ADM was used and if any comparisons between the 2 types of ADM were made. Ten studies explicitly identified RTU as the product used. Of those, 2 studies were eliminated because their populations were included in a later, more comprehensive report from the same group. Of the remaining 8 studies, only 5 studies contained data that compared outcomes between RTU and FD (Fig. 1).


A Meta-analysis Assessing Postsurgical Outcomes between Aseptic and Sterile AlloDerm Regenerative Tissue Matrix.

Macarios D, Griffin L, Chatterjee A, Lee LJ, Milburn C, Nahabedian MY - Plast Reconstr Surg Glob Open (2015)

Prisma flow diagram. A total of 275 records were identified through literature searches. The majority of articles (n = 160) did not identify the sterile product explicitly. Of the remaining, 103 did not have comparative data or were duplicates, leaving 5 studies for qualitative synthesis and 3 for meta-analysis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494479&req=5

Figure 1: Prisma flow diagram. A total of 275 records were identified through literature searches. The majority of articles (n = 160) did not identify the sterile product explicitly. Of the remaining, 103 did not have comparative data or were duplicates, leaving 5 studies for qualitative synthesis and 3 for meta-analysis.
Mentions: A total of 235 unique citations were retrieved and an additional 40 articles were found by manually searching the aforementioned plastic surgery journals. From the 275 identified citations, 115 were eligible for full review to determine which type of ADM was used and if any comparisons between the 2 types of ADM were made. Ten studies explicitly identified RTU as the product used. Of those, 2 studies were eliminated because their populations were included in a later, more comprehensive report from the same group. Of the remaining 8 studies, only 5 studies contained data that compared outcomes between RTU and FD (Fig. 1).

Bottom Line: Included studies compared both RTU and FD.Results remained nonsignificant even after adjustment for variable follow-up time.The results suggest that there are no differences in complication rates between RTU and FD forms.

View Article: PubMed Central - PubMed

Affiliation: LifeCell, an Acelity Company, Bridgewater, N.J.; Acelity, San Antonio, Tex.; Divisions of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania Hospital, Philadelphia, Pa.; and Department of Plastic Surgery, Georgetown University, Washington, D.C.

ABSTRACT

Background: AlloDerm, a human acellular dermal matrix, is available in a ready-to-use (RTU) or freeze-dried (FD) form. A limited number of studies have compared complication rates between RTU and FD in implant-based breast reconstruction. The objective of this report was to conduct a meta-analysis of previously reported complication rates between RTU and FD.

Methods: A systematic literature review was conducted from 2010 to 2014 and supplemented by hand searches. Included studies compared both RTU and FD. Odds ratios and relative risks (RRs) with 95% confidence interval (CI), taking into account study heterogeneity, were calculated. Studies reporting patient-level results as opposed to breast-level results were excluded from the primary analysis but included in subsequent sensitivity analyses. Variable follow-up time within and between studies was also considered in a sensitivity analysis.

Results: Of the 275 identified studies, 115 studies were eligible for detailed review. Only 5 studies compared RTU with FD, and of these, 2 studies had breast-level data and 1 study had patient-level data appropriate for meta-analysis. The 2 studies included in the primary meta-analysis had a pooled sample size: n = 116 RTU and n = 109 FD patients, or 205 and 186 breasts, respectively. Age and body mass index were similar between groups. Across all meta-analyses, there were no differences in complication rates between RTU and FD: cellulitis (RR = 0.863; 95% CI, 0.272-2.740), seroma (RR = 0.553; 95% CI, 0.026-11.830), and explantation (RR = 0.593; 95% CI, 0.247-1.425). Results remained nonsignificant even after adjustment for variable follow-up time.

Conclusion: The results suggest that there are no differences in complication rates between RTU and FD forms.

No MeSH data available.


Related in: MedlinePlus