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Brief Communication Plastic and Aesthetic Research

Meshed acellular dermal matrix: technique

and application in implant based breast

reconstruction

Dino Zammit , Jonathan Kanevsky , Fan-Yi Meng , Tassos Dionisopoulos 3
1
1
1,2
1 Plastic Surgery, Faculty of Medicine, McGill University, Montreal, Quebec H3G 1A4, Canada.
2 Montreal General Hospital, McGill University, Montreal, Quebec H3G 1A4, Canada.
3 Jewish General Hospital, McGill University, Montreal, Quebec H3G 1A4, Canada.
Correspondence Author: Dr. Jonathan Kanevsky, Montreal General Hospital, McGill University, Montreal, Quebec H3G 1A4, Canada.
E-mail: jonkanevsky@gmail.com

ABSTRACT
Alloderm was the first acellular dermal matrix used and remains a popular choice among plastic
surgeons. However, while the overall surgical outcome of breast reconstruction using alloderm
has been a success, the economic burden on the health care system makes it a subject of frequent
re-evaluations in cost-effectiveness. Prompted by the high price of $3,700 USD for a 6 cm × 16 cm
area, our group proposes the meshing of AlloDerm to decrease the total amount needed for breast
reconstruction, while achieving comparable surgical outcomes as using unmeshed alloderm.
Key words:
Alloderm; acellular dermal matrix; breast reconstruction; meshing; breast cancer

INTRODUCTION thickness grafts can be processed through meshing,
therefore increasing promoting improved adherence to
The use of acellular dermal matrices (ADM) in breast the wound. To date, there have been no reports in the
reconstruction has grown in popularity in the last literature on using meshed alloderm routinely for breast
decade, stemming from the increase in implant based reconstruction surgery.
reconstruction requiring adequate lower pole coverage.
[1]
Our idea of meshing ADM originates from a common Alloderm is an acellular human tissue matrix derived from
[3]
surgical technique used for skin grafting. cadaveric tissue that exhibits regenerative properties. All
donor cells and allergenic epitopes are removed, leaving
Skin grafts can be classified broadly into two groups: a collagen scaffold, growth factor receptors, and vascular
split-thickness grafts that contain a portion of the channels that aid in tissue regeneration with minimum
dermis, and full-thickness grafts that contain the entire scarring and fibrosis. The utility of alloderm is based on
dermis. An advantage of split-thickness grafts over full- its ability to integrate and promote neovascularization
thickness grafts is that they can survive in less vascular
conditions, but are more prone to contracting. Split- This is an open access article distributed under the terms of the Creative
[2]
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How to cite this article: Zammit D, Kanevsky J, Meng FY,
Dionisopoulos T. Meshed acellular dermal matrix: technique and
DOI: application in implant based breast reconstruction. Plast Aesthet
10.20517/2347-9264.2015.128 Res 2016;3:254-6.
Received: 17-12-2015; Accepted: 07-06-2016
254 © 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc.