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Background <p>Acellular dermal matrix (ADM) is widely used in tissue expander and implant-based breast reconstruction because of its ability to enhance soft tissue support and improve aesthetic outcomes. Despite its popularity, concerns regarding postoperative complications persist. This systematic review and meta-analysis aimed to assess the complication rates associated with ADM use in these procedures.</p> Methods <p>A systematic search of six electronic databases was conducted, and ten studies including 2,399 patients were included. Data on necrosis, seroma, infection, hematoma, capsular contracture, implant exposure, and reoperation rates were extracted and analyzed. Risk ratios with 95% confidence intervals were calculated using a random-effects model.</p> Results <p>ADM use was associated with a significantly reduced risk of capsular contracture (RR = 0.39; 95% CI, 0.24–0.63;&#xa0;<i>P</i> &lt; 0.0001). However, the risks of implant exposure (RR = 1.59; 95% CI, 1.08–2.34;&#xa0;<i>P</i> = 0.02) and infection (RR = 1.38; 95% CI, 1.03–1.86;&#xa0;<i>P</i> = 0.03) were significantly increased. No significant differences were observed in other complications, including seroma, necrosis, and reoperation.</p> Conclusions <p>Although ADM reduces the risk of capsular contracture, it may increase implant-related complications. These findings highlight the importance of careful patient selection and meticulous surgical technique. Further randomized controlled trials with standardized outcome reporting are needed to better define the risk–benefit profile of ADM in breast reconstruction.</p> Level of evidence <p>Not gradable.</p>

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Impact of acellular dermal matrix use on postoperative outcomes in tissue expander/implant-based breast reconstruction: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年12月12日

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  • Jawahir O. AlTamimi,
  • Abdulaziz M. Alghamdi,
  • Abdulaziz F. Samander,
  • Abdulaziz B. Fathi,
  • Raneem M. Turkistani,
  • Mohammad K. Al Jehani,
  • Noor H. Allababidi,
  • Fareeda S. AlGhamdi,
  • Sultan K. AlMubarak,
  • Ezdehar Fallatah

摘要

Background

Acellular dermal matrix (ADM) is widely used in tissue expander and implant-based breast reconstruction because of its ability to enhance soft tissue support and improve aesthetic outcomes. Despite its popularity, concerns regarding postoperative complications persist. This systematic review and meta-analysis aimed to assess the complication rates associated with ADM use in these procedures.

Methods

A systematic search of six electronic databases was conducted, and ten studies including 2,399 patients were included. Data on necrosis, seroma, infection, hematoma, capsular contracture, implant exposure, and reoperation rates were extracted and analyzed. Risk ratios with 95% confidence intervals were calculated using a random-effects model.

Results

ADM use was associated with a significantly reduced risk of capsular contracture (RR = 0.39; 95% CI, 0.24–0.63; P < 0.0001). However, the risks of implant exposure (RR = 1.59; 95% CI, 1.08–2.34; P = 0.02) and infection (RR = 1.38; 95% CI, 1.03–1.86; P = 0.03) were significantly increased. No significant differences were observed in other complications, including seroma, necrosis, and reoperation.

Conclusions

Although ADM reduces the risk of capsular contracture, it may increase implant-related complications. These findings highlight the importance of careful patient selection and meticulous surgical technique. Further randomized controlled trials with standardized outcome reporting are needed to better define the risk–benefit profile of ADM in breast reconstruction.

Level of evidence

Not gradable.