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Comparison of the Characteristics of Three Acellular Dermal Matrices Subjected to Distinct Processing Methods Using Five Types of Histochemical Staining

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  • Breast Surgery
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Abstract

Background

Acellular dermal matrix (ADM) is treated using various devitalization and aseptic processing methods. The processing effects on ADM were evaluated by histochemical tests.

Methods

From January 2014 to December 2016, 18 patients [average age, 43.0 (range, 30–54) years] who underwent breast reconstruction with an ADM and tissue expander were prospectively enrolled. During the permanent implant replacement, a biopsy of the ADM was performed. We used three different human-derived products, namely, Alloderm®, Allomend®, and Megaderm®. Hematoxylin and eosin, CD68, CD3, CD31, and smooth muscle actin were used to evaluate the collagen structure, inflammation, angiogenesis, and myofibroblast infiltration. Each ADM was semi-quantitatively analyzed.

Results

Significant differences in collagen degradation, acute inflammation, and myofibroblast infiltration were observed among the ADMs. Collagen degeneration (p<0.001) and myofibroblast infiltration (smooth muscle actin-positive, p=0.018; CD31-negative, p=0.765) were the most severe in Megaderm®. Acute inflammation, represented by CD68, was most severe in Alloderm® (p=0.024). Both radiation and freeze-drying treatment physically damaged the collagen structure. Collagen degeneration was most severe in Megaderm®, followed by Allomend® and Alloderm®. Since Alloderm® is treated using chemicals, an assessment of the chemical irritation is warranted.

Conclusions

The biopsy results were inconclusive. Therefore, to better interpret processing, more large-scale, serial, histochemical studies of each ADM are needed.

Level of Evidence IV

This journal requires that authors 38 assign a level of evidence to each article. For a full 39 description of these Evidence-Based Medicine ratings, 40 please refer to the Table of Contents or the online 41 Instructions to Authors www.springer.com/00266.

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Acknowledgments

We would like to thank Editage (www.editage.com) for English language editing and publication support.

Funding

This research received no external funding.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Byung Woo Yoo, Yu Taek Kong, Kyu Nam Kim & Junekyu Kim

  2. Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Seoung Wan Chae & Boram Song

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  1. Byung Woo Yoo
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  4. Kyu Nam Kim
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Correspondence to Junekyu Kim.

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The authors declare no conflict of interest.

Informed Consent

Written informed consent was obtained from all subjects involved in the study. Written informed consent has also been obtained from the patients to publish this paper.

Ethical Approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Kangbuk Samsung Hospital (IRB no. KBSMC 2021-09-038; date of approval: November 26th, 2021).

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Yoo, B.W., Kong, Y.T., Chae, S.W. et al. Comparison of the Characteristics of Three Acellular Dermal Matrices Subjected to Distinct Processing Methods Using Five Types of Histochemical Staining. Aesth Plast Surg 47, 1315–1323 (2023). https://doi.org/10.1007/s00266-023-03318-x

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