Immediate breast reconstruction using porcine acellular dermal matrix (Strattice™): Long-term outcomes and complications

Background: There has been limited reported experience with the use of Strattice™ (LifeCell Corp., Branchburg, NJ), a porcine-derived acellular dermal matrix, in implant-based breast reconstruction. The purpose of this study is to evaluate our experience with this matrix. Methods: Patients who underwent immediate single-stage or two-stage implant-based breast reconstruction with the assistance of Strattice were included in this study. Patient charts were reviewed for indications for mastectomy, adjunctive radiotherapy use, implant or expander volume, length of follow-up period, and type and incidence of complications during the follow-up period. Biopsies of Strattice were taken for histological analyses. Results: A total of 105 reconstructions were performed in 54 patients: 77% were prophylactic and 23% were oncologic. All, but 4, reconstructions were single stage. Mean implant volume of single-stage reconstructions were 444.1 (range: 150-700 cc) and mean expander volume after completion of expansion was 400 (range: 350-450). Mean follow-up period was 41.3 months (range: 35.5-48.4 months). Total complication rate was 8.6%. Complications occurred in 9 breasts: implant loss or explantation (3.8%), infection (3.8%), skin breakdown or necrosis (2.9%), seroma (1.9%), implant exposure (1.0%), and delayed skin healing (1.0%). Histological analyses of implanted Strattice revealed a viable matrix with fibroblast infiltration and revascularization. Conclusions: Over a mean 3.5-year follow-up period, low complication rates and good outcomes were observed with the use of Strattice that are comparable to those reported with human acellular dermal matrices.