The partial AlloDerm™ sling: Reducing allograft costs associated with breast reconstruction
Section snippets
Study design
We retrospectively studied outcomes of 145 consecutive patients who underwent delayed or immediate breast reconstruction with tissue expanders (CPT 19357) and ADM by a single surgeon from 2007 to 2010. The chart review was approved by our institutional review board. Preoperative data recorded included age, body mass index, medical history, prior breast surgery and breast measurements. Breast measurements included sternal notch to nipple, nipple to IMF and base width. Intra-operative
Results
From 2007 to 2010, 145 women (197 breasts) aged 21–78 years (mean 50.4 years) underwent immediate or delayed breast reconstruction using tissue expanders by a single surgeon. Of the 197 mastectomies performed, 93 were unilateral and 52 were bilateral (Table 1). Mastectomy techniques used were skin-sparing (124 patients), nipple-sparing (37 patients), complete mastectomy or modified radial mastectomy (34 patients). Two patients had previously undergone mastectomy and underwent delayed
Discussion
Immediate or delayed expander-based breast reconstruction remains the most commonly performed technique.2 The use of ADM to create an expander or implant pocket decreases operative time, patient morbidity and improves aesthetic outcomes when compared to full muscular coverage.3, 8 One of the drawbacks to its use is the associated cost ($30/cm2).12
The amount of ADM used varies by surgeon and the type of reconstruction. Spear et al. preoperatively measure the arc length of the IMF and use either
Conflict of interest
No authors have any financial conflict of interest to report.
Financial disclosure
No funding was received for this work.
Ethical standards
The presented work has been approved by the University Hospitals – Case Medical Center Institutional Review Board (#05-10-24).
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