Background and Objective

Due to the high cost and the difficulty in acquiring acellular dermal matrices or other biological substitutes in our medium, we use autologous dermis matrices (ADM) obtained from abdominal scars, previous caesarean incisions, abdominoplasties, contralateral breast, or other areas, during immediate o deferred breast reconstruction, in order to reinforce the lower pole of the pectoral muscle and to avoid prosthetic extrusion by ensuring the submammary fold.

By using these autologous tissues we present a real, safe, simple and accessible alternative that lowers costs and present our experience on the use of ADM in breast reconstruction.

Methods

We obtain ADM mainly from the suprapubic area, previous scars of caesarean incision, tummy tucks, contralateral breast and even from other regions of the body (torsoplasty), either in the first or in the second surgical stage, in immediately or deferred breast reconstruction.

The acquisition of the dermal matrix is technically simple. We first mark the area to be resected, then we decorticate the skin to obtain the dermis segment and finally we preserve it in a physiological solution until time to be used.

Results

Thirty three patients were registered: 7 with deferred surgeries and 26 with immediate reconstruction. We obtained the ADM from the contra lateral breast in 3 patients, from the thoracic region of a torso scar in 1 woman and from suprapubic region, caesarean incisions scars , tummy tucks or even new incisions in the rest of the patients.

We only had 1 immediate seroma case that yielded to the 7th day in a patient from a deferred reconstruction None of the presented cases evolved with wound infection, dehiscence, implant extrusion or technique failure over a 1-year postoperative clinical follow-up.

Conclusions

In our experience, the use of ADM in breast reconstruction represents a good alternative, safe, accessible and low economic technic, which does not prolong the surgical time and with no complications in obtaining and application.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )