Comparing Cortiva Silhouette to AlloDerm for Use in Prepectoral Two-stage Prosthetic Breast Reconstruction.

Background: The use of acellular dermal matrices (ADMs) in implant-based breast reconstruction has become increasingly routine during the past 20 years. ADMs improve soft-tissue support, facilitate greater tissue expander (TE) fill volumes, and reduce rates of capsular contracture. As the ADM market continues to grow, outcomes studies are necessary to assess the risks and benefits of each product.

Cortiva versus AlloDerm in Prepectoral and Partial Submuscular Implant-Based Breast Reconstruction: A Randomized Clinical Trial.

Background: Several acellular dermal matrices (ADMs) are used for soft-tissue support in prosthetic breast reconstruction. Little high-level evidence supports the use of one ADM over another. The authors sought to compare Cortiva 1-mm Allograft Dermis with AlloDerm RTU (ready to use), the most studied ADM in the literature.

Clinical efficacy of soft-tissue augmentation on tissue preservation at immediate implant sites: A randomized controlled trial.

Aim: This randomized controlled trial aimed to investigate the efficacy of soft-tissue augmentation (STA) with a subepithelial connective tissue graft (SCTG) or an acellular dermal matrix (ADM) on reducing tissue alterations at an immediate implant site.

Materials And Methods: This trial had three groups: (i) immediate implant with SCTG (ICT group); (ii) immediate implant with ADM (IAD group); (iii) immediate implant without STA (control group). Forty-six patients were randomly assigned to each group.

Evaluation of Xenograft Efficacy in Immediate Prosthesis-based Breast Reconstruction.

Unlabelled: The advent of acellular dermal matrix (ADM) has revolutionized prosthesis-based breast reconstruction. However, paucity of human cadaveric tissue has resulted in limitation of supply and increased associated costs, prompting concerted effort to identify xenograft alternatives. Although studies have examined the safety of Artia, a porcine-derived ADM, few have evaluated its clinical efficacy as soft tissue reinforcement.

In-Vivo Evaluation of a Reinforced Ovine Biologic for Plastic and Reconstructive Procedures in a Non-human Primate Model of Soft Tissue Repair.

Background: Biologic matrices are used in plastic and reconstructive surgical procedures to aid in the kinetics of soft tissue repair and promote functional tissue formation. The human acellular dermal matrix AlloDerm is widely used; however, it is offered at a relatively high cost, and its dermal composition may not provide an ideal remodeling scaffold. OviTex Plastic and Reconstructive Surgery (PRS) Resorbable and Permanent are reinforced biologic matrices engineered with layers of ovine forestomach matrix embroidered with small amounts of polymer to optimize biophysical performance.

Characterization of Inflammatory and Fibrotic Aspects of Tissue Remodeling of Acellular Dermal Matrix in a Nonhuman Primate Model.

Unlabelled: Human acellular dermal matrices (hADMs) are applied in various soft tissue reconstructive surgeries as scaffolds to support tissue remodeling and regeneration. To evaluate the clinical efficacy of hADM implants, it is integral that the hADM does not induce a host chronic inflammatory response leading to fibrotic encapsulation of the implant. In this study, we characterized the inflammatory and fibrosis-related tissue remodeling response of 2 commercial hADM products (SimpliDerm and AlloDerm RTU) in a nonhuman primate model using histology and gene expression profiling.

Cortiva Versus AlloDerm Ready-to-use in Prepectoral and Submuscular Breast Reconstruction: Prospective Randomized Clinical Trial Study Design and Early Findings.

Background: Several acellular dermal matrices (ADMs) can be used to provide soft-tissue support for post- and prepectoral prosthetic breast reconstructions. Yet, several recent meta-analysis suggest that due to a lack of rigorous evaluation in the setting of head-to-head prospective randomized control trials, few reliable conclusions regarding performance outcomes can be drawn. We compare Cortiva 1 mm to AlloDerm RTU in the setting of submuscular reconstruction in one study, and prepectoral in the second.

Revascularization of AlloDerm Used during Endoscopic Skull Base Surgery.

 AlloDerm is an acellular dermal matrix often used for reconstruction throughout the body. AlloDerm has been shown to undergo revascularization when used to reconstruct soft tissue such as in abdominal wall reconstruction. In this study, the authors review the literature on revascularization of AlloDerm and demonstrate the histologic findings of AlloDerm after implantation during skull base reconstruction.

Failure of Synthetic Implants: Strategies and Management.

Dorsal augmentation with synthetic implants is the most commonly performed rhinoplasty procedure, especially in the East-Asian region. However, as in all other surgical procedures, complications are inevitable. Complications that need to be managed surgically include displacement, deviation, suboptimal aesthetic outcome, extrusion, inflammation, infection, and changes in skin quality.

Barbed Ribbon Device for Progressive Tension Closure Reduces Seroma After Breast Reconstruction.

Purpose: Implant-based breast reconstruction is fraught with complications related to seroma formation. Soft tissue stabilization with progressive tension closure (PTC) has been shown to decrease seroma formation after various procedures but is less suitable for mastectomy flap stabilization. We evaluate the incidence of seroma in breast reconstruction using bioabsorbable barbed ribbon devices (BRDs) as a novel approach to PTC.

The use of acellular dermal matrix membrane for vertical soft tissue augmentation during submerged implant placement: a case series.

Objective: To evaluate the efficiency of acellular dermal matrix membrane to augment vertical peri-implant soft tissue thickness during submerged implant placement.

Material And Methods: Forty acellular dermal matrix-derived allogenic membranes (AlloDerm, BioHorizons, Birmingham, AL, USA) and 42 laser-modified surface internal hex implants (BioHorizons Tapered Laser Lok, Birmingham, AL, USA) were placed in submerged approach in 40 patients (15 males and 25 females, mean age 42.5 ± 1.

Comparative host response of 2 human acellular dermal matrices in a primate implant model.

Objective: We examined the differences in capsule formation between 2 commercially available human acellular dermal matrices in a nonhuman primate model.

Methods: Primates were implanted dorsally with a subcutaneously placed tissue expander and randomized into 3 groups, receiving skin coverage only, coverage with non-irradiated freeze-dried human acellular dermal matrix, or coverage with gamma-irradiated human acellular dermal matrix. After 9 weeks, soft tissue around the tissue expander was excised and evaluated qualitatively and quantitatively to assess extent of inflammation (CD68 antibodies and interleukin-6 levels), degradation and fibrosis (matrix metalloproteinase-1 and procollagen-1 staining), and mechanical (tensile) strength.

Multilayer cell-seeded polymer nanofiber constructs for soft-tissue reconstruction.

Importance: Cell seeding throughout the thickness of a nanofiber construct allows for patient-specific implant alternatives with long-lasting effects, earlier integration, and reduced inflammation when compared with traditional implants. Cell seeding may improve implant integration with host tissue; however, the effect of cell seeding on thick nanofiber constructs has not been studied.

Objective: To use a novel cell-preseeded nanofiber tissue engineering technique to create a 3-dimensional biocompatible implant alternative to decellularized extracellular matrix.

Options to avoid the second surgical site: a review of literature.

As esthetics gain importance, periodontal plastic surgical procedures involving soft tissue grafts are becoming commoner both around natural teeth as well as around implants. Periodontal soft tissue grafts are primarily used for the purpose of root coverage and in pre-prosthetic surgery to thicken a gingival site or to improve the crestal volume. Soft tissue grafts are usually harvested from the palate.

Use of AlloDerm in primary reconstruction after resection of squamous cell carcinoma of the lip and oral commissure.

AlloDerm (LifeCell Corporation, Branchburg NJ) is an acellular dermal homograft processed from human cadaveric skin. AlloDerm has been used successfully for soft tissue reconstruction due to its lack of immunogenicity and minimal absorption. In the lip, it has been utilized for aesthetic lip augmentation and as an injectable filler.

A systematic review of acelluar dermal matrices in head and neck reconstruction.

Background: The use of acellular dermal matrices has been well described in the scientific literature since the early 1990 s and has been utilized for multiple applications in the head and neck for both aesthetic and reconstructive efforts.

Methods: After systematically searching the PubMed database and following further refinement (based on the authors' inclusion and exclusion criteria), the authors identified 30 studies that provided information about patients who had undergone head and neck reconstruction with the use of acellular dermal matrix. Studies had to report quantifiable objective results in patients who were older than 1 year and younger than 90 years.

Using soft tissue graft to prevent mid-facial mucosal recession following immediate implant placement.

Background: With advances in dental technology, the placement of immediate implants has progressively gained popularity. However, a common complication that surfaced was mid-facial mucosal recession, which impaired esthetic outcomes. The use of soft tissue grafts has thus been introduced to manage and prevent this undesirable result.

Implant-supported single tooth restoration in the aesthetic zone: transmucosal and submerged healing provide similar outcome when simultaneous bone augmentation is needed.

Aim: The aim of this study was to compare the clinical outcomes after 2 years with bone level implants placed to restore a single missing teeth that needed simultaneous augmentation and were treated with a transmucosal or submerged approach.

Methods: This study analyzed a subset of patients included in an ongoing prospective multicenter randomized clinical trial (RCT) involving12 centers where patients were to be followed-up to 5 years after loading. Of the 120 implants that were placed in the original study, and randomly assigned to submerged or non-submerged healing, 52 needed simultaneous augmentation (28 women patients and 24 men patients, between 23 and 78 years of age).

Custom porous polyethylene implants for large-scale pediatric skull reconstruction: early outcomes.

Background And Purpose: Some of the most problematic craniofacial injuries in pediatric plastic surgery are large calvarial defects in children who have passed the age of maximal dural osteogenic potential and yet are too young to yield split calvarial grafts. Porous polyethylene (Medpor; Porex) is an alloplastic material that can be customized to precisely match a cranial defect. We present a clinical series that demonstrates successful use of porous polyethylene cranioplasties in large pediatric cranial defects.

Esthetic soft tissue ridge augmentation around dental implant: Case report.

The aim of this case report is to present a method to correct soft tissue ridge deformity around dental implant using acellular dermal matrix (ADM). A 25-year-old female patient presented with a missing maxillary first left premolar, which had class I soft tissue defect. The missing tooth was replaced with single implant supported prosthesis and the soft tissue defect was corrected using ADM utilizing the envelop technique.

A comparative, long-term assessment of four soft tissue substitutes.

Background: The ideal product for soft tissue replacement is durable, nonimmunogenic, and noninfectious. AlloDerm (LifeCell Corp., Branchburg, New Jersey), Enduragen (Stryker Corp.

Tissue expander breast reconstruction using prehydrated human acellular dermis.

Introduction: Human acellular dermal matrices help facilitate immediate tissue expander-implant breast reconstruction by providing support to the inferolateral pole, improving control of implant position, and enhancing early volume expansion. Although several freeze-dried human acellular dermal products have demonstrated reasonable safety and efficacy in immediate tissue expander-implant breast reconstruction, no dedicated studies have evaluated clinical outcomes of prehydrated human acellular dermal matrix (PHADM) in breast reconstruction.

Methods: The outcomes of 121 consecutive tissue expander reconstructions performed by the senior author using PHADM were evaluated.

Allograft (Alloderm) and autograft (temporalis fascia) implantation for glottic insufficiency: a novel approach.

Objective: Traditionally, glottic insufficiency because of scar, atrophy, and sulcus has been treated by injection or medialization laryngoplasty. These procedures do not reestablish the vertical height of the vocal fold margin. We propose soft tissue augmentation laryngoplasty with allograft (sheet Alloderm; LifeCell Corporation, Branchburg, NJ) or autograft (temporalis fascia) via a minithyrotomy or a transoral approach.

Immediate implantation with ridge augmentation using acellular dermal matrix and deproteinized bovine bone: a case report.

Immediate implant placement combined with hard and soft tissue grafting has been suggested because it may preclude dramatic postextraction bone loss and may decrease overall discomfort with reduction in the number of surgeries and in treatment time. In this case report, the acellular dermal matrix was used as a membrane for immediate implantation via a bone augmentation procedure in an esthetically challenging situation. The author suggests that this surgical technique provides the clinician with an option for an immediate implant therapy when primary closure is not intended.