TY - JOUR
T1 - Improving long-term projection in nipple reconstruction using human acellular dermal matrix
T2 - An animal model
AU - Holton, L. H.
AU - Haerian, Hafez
AU - Silverman, Ronald P.
AU - Chung, Thomas
AU - Elisseeff, Jennifer H.
AU - Goldberg, Nelson H.
AU - Slezak, Sheri
PY - 2005/9
Y1 - 2005/9
N2 - Reconstructed nipples rapidly lose projection. We describe the use of human acellular dermal matrix (ADM) to improve long-term projection of nipple flaps. Athymic rats were randomized to 3 groups; each received 2 nipples: bell flap (control, n = 16 nipples), bell flap with a cylinder of implanted ADM (n = 24), or bell flap with intraflap injection of micronized ADM (MADM) (n = 10). Seven of 24 ADM nipples extruded (30%). By 12 weeks, the control nipples maintained 44% of initial projection compared with 70% for ADM nipples (P = 0.000025). The MADM nipples maintained 49% of initial projection after 12 weeks (P = 0.55 compared with control). No MADM nipples extruded. ADM grafts maintain long-term projection better than local tissue flaps alone. We hypothesize that MADM may limit extrusion and allow for serial injection of nipples. Based on the promising results of this study, clinical trials are warranted using human ADM and/or human MADM for nipple reconstruction.
AB - Reconstructed nipples rapidly lose projection. We describe the use of human acellular dermal matrix (ADM) to improve long-term projection of nipple flaps. Athymic rats were randomized to 3 groups; each received 2 nipples: bell flap (control, n = 16 nipples), bell flap with a cylinder of implanted ADM (n = 24), or bell flap with intraflap injection of micronized ADM (MADM) (n = 10). Seven of 24 ADM nipples extruded (30%). By 12 weeks, the control nipples maintained 44% of initial projection compared with 70% for ADM nipples (P = 0.000025). The MADM nipples maintained 49% of initial projection after 12 weeks (P = 0.55 compared with control). No MADM nipples extruded. ADM grafts maintain long-term projection better than local tissue flaps alone. We hypothesize that MADM may limit extrusion and allow for serial injection of nipples. Based on the promising results of this study, clinical trials are warranted using human ADM and/or human MADM for nipple reconstruction.
KW - Acellular dermal matrix
KW - Micronized acellular dermal matrix
KW - Nipple projection
KW - Nipple reconstruction
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U2 - 10.1097/01.sap.0000171679.78456.62
DO - 10.1097/01.sap.0000171679.78456.62
M3 - Article
C2 - 16106172
AN - SCOPUS:24044505370
SN - 0148-7043
VL - 55
SP - 304
EP - 309
JO - Annals of plastic surgery
JF - Annals of plastic surgery
IS - 3
ER -