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A Head-to-head Comparison between SurgiMend and Epiflex in 127 Breast Reconstructions.

Eichler C, Vogt N, Brunnert K, Sauerwald A, Puppe J, Warm M - Plast Reconstr Surg Glob Open (2015)

Bottom Line: Severe complications requiring revision surgery were significantly increased in patients treated with Epiflex (12.5%) compared with SurgiMend (4.8%).This retrospective analysis favors the use of SurgiMend over Epiflex because of significantly lower gross complication rates.Although results promote the use of SurgiMend, the single surgeon retrospective nature of this work limits its clinical impact.

View Article: PubMed Central - PubMed

Affiliation: Breast Center, Municipal Hospital Holweide, Cologne, Germany; Department of Gynecology and Obstetrics, Municipal Hospital Holweide, Cologne, Germany; Department of Senology, Clinic for Senology, Osnabrueck, Germany; Department of Gynecology and Obstetrics, Hospital Düren GmbH, Düren, Germany; and Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany.

ABSTRACT

Background: The use of acellular dermal matrices (ADM) has become a widely used option in breast reconstruction. A great deal of literature is available, totaling over 2400 ADM reconstructions. Nonetheless, head-to-head comparisons between SurgiMend and Epiflex are not yet reported. In fact, this is the first clinical data report on the use of Epiflex. This work will, therefore, compare postoperative complication rates and costs for these ADMs.

Methods: This analysis is a retrospective review of a single surgeon's 6-year experience with both SurgiMend-an acellular bovine dermal collagen matrix for soft-tissue reconstruction and Epiflex-a decellularized human skin tissue from 2008 to 2013.

Results: One hundred patients had a total of 127 implant-based reconstructions using SurgiMend (64 cases; 50.4%) or Epiflex (63 cases; 49.6%). Gross complication rates were 11.1% for SurgiMend and 40.6% for Epiflex including hematoma, postoperative skin irritation, infection, necrosis, and revision surgery. The most common complication was postoperative red breast syndrome. Severe complications requiring revision surgery were significantly increased in patients treated with Epiflex (12.5%) compared with SurgiMend (4.8%).

Conclusions: This retrospective analysis favors the use of SurgiMend over Epiflex because of significantly lower gross complication rates. Severe complication rates are comparable with those reported in literature for both products. Although results promote the use of SurgiMend, the single surgeon retrospective nature of this work limits its clinical impact.

No MeSH data available.


Related in: MedlinePlus

SurgiMend PRS is derived from fetal bovine dermal collagen. This image shows a fenestrated 10 × 15 cm ADM.
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Figure 3: SurgiMend PRS is derived from fetal bovine dermal collagen. This image shows a fenestrated 10 × 15 cm ADM.

Mentions: SurgiMend PRS (TEI, Biosciences, Inc., Boston, Mass.) is derived from fetal bovine dermal collagen (Fig. 3). Apart from advantageous mechanical properties,15 the manufacturer states it to be rich in type III collagen, which may mediate tissue healing while inhibiting scarring.16 It may also not elicit an acute or chronic foreign body inflammatory response thus eliminating degeneration of the implant site. Furthermore, its microporous matrix is rapidly revascularized, which, in turn, may support tissue building and healing for prolonged reinforcement.17 It is the only biological mesh with fenestration, theoretically allowing fluid accumulations around the implant to drain into the surrounding tissue.2 A PubMed search currently (October 2014) lists 8 publications regarding the SurgiMend ADM. Ohkuma et al8 (65 patients, retrospective) and Butterfield et al4 (222 patients) are two retrospective analyses available in breast reconstruction to date.


A Head-to-head Comparison between SurgiMend and Epiflex in 127 Breast Reconstructions.

Eichler C, Vogt N, Brunnert K, Sauerwald A, Puppe J, Warm M - Plast Reconstr Surg Glob Open (2015)

SurgiMend PRS is derived from fetal bovine dermal collagen. This image shows a fenestrated 10 × 15 cm ADM.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494509&req=5

Figure 3: SurgiMend PRS is derived from fetal bovine dermal collagen. This image shows a fenestrated 10 × 15 cm ADM.
Mentions: SurgiMend PRS (TEI, Biosciences, Inc., Boston, Mass.) is derived from fetal bovine dermal collagen (Fig. 3). Apart from advantageous mechanical properties,15 the manufacturer states it to be rich in type III collagen, which may mediate tissue healing while inhibiting scarring.16 It may also not elicit an acute or chronic foreign body inflammatory response thus eliminating degeneration of the implant site. Furthermore, its microporous matrix is rapidly revascularized, which, in turn, may support tissue building and healing for prolonged reinforcement.17 It is the only biological mesh with fenestration, theoretically allowing fluid accumulations around the implant to drain into the surrounding tissue.2 A PubMed search currently (October 2014) lists 8 publications regarding the SurgiMend ADM. Ohkuma et al8 (65 patients, retrospective) and Butterfield et al4 (222 patients) are two retrospective analyses available in breast reconstruction to date.

Bottom Line: Severe complications requiring revision surgery were significantly increased in patients treated with Epiflex (12.5%) compared with SurgiMend (4.8%).This retrospective analysis favors the use of SurgiMend over Epiflex because of significantly lower gross complication rates.Although results promote the use of SurgiMend, the single surgeon retrospective nature of this work limits its clinical impact.

View Article: PubMed Central - PubMed

Affiliation: Breast Center, Municipal Hospital Holweide, Cologne, Germany; Department of Gynecology and Obstetrics, Municipal Hospital Holweide, Cologne, Germany; Department of Senology, Clinic for Senology, Osnabrueck, Germany; Department of Gynecology and Obstetrics, Hospital Düren GmbH, Düren, Germany; and Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany.

ABSTRACT

Background: The use of acellular dermal matrices (ADM) has become a widely used option in breast reconstruction. A great deal of literature is available, totaling over 2400 ADM reconstructions. Nonetheless, head-to-head comparisons between SurgiMend and Epiflex are not yet reported. In fact, this is the first clinical data report on the use of Epiflex. This work will, therefore, compare postoperative complication rates and costs for these ADMs.

Methods: This analysis is a retrospective review of a single surgeon's 6-year experience with both SurgiMend-an acellular bovine dermal collagen matrix for soft-tissue reconstruction and Epiflex-a decellularized human skin tissue from 2008 to 2013.

Results: One hundred patients had a total of 127 implant-based reconstructions using SurgiMend (64 cases; 50.4%) or Epiflex (63 cases; 49.6%). Gross complication rates were 11.1% for SurgiMend and 40.6% for Epiflex including hematoma, postoperative skin irritation, infection, necrosis, and revision surgery. The most common complication was postoperative red breast syndrome. Severe complications requiring revision surgery were significantly increased in patients treated with Epiflex (12.5%) compared with SurgiMend (4.8%).

Conclusions: This retrospective analysis favors the use of SurgiMend over Epiflex because of significantly lower gross complication rates. Severe complication rates are comparable with those reported in literature for both products. Although results promote the use of SurgiMend, the single surgeon retrospective nature of this work limits its clinical impact.

No MeSH data available.


Related in: MedlinePlus