D82. Acellular Dermal Matrix-assisted, Implant-based Breast Reconstruction: A Comparison of SurgiMend, AlloDERM, and DermACELL

PURPOSE: Acellular dermal matrices (ADMs) are frequently employed during implant-based breast reconstruction (IBBR) to provide structural support and optimize outcomes. ADMs differ in derivative (fetal bovine, porcine, human), cost and processing; yet few studies directly compare their outcomes. We sought to compare outcomes across three ADMs: SurgiMend (bovine-derived), AlloDerm (human-derived), and DermACELL (human-derived). METHODS: A multicenter retrospective review of patients receiving IBBR with SurgiMend, AlloDerm, or DermACELL between January 2014 and July 2022 was performed. Primary outcomes included explantation or total reconstructive failure. Secondary outcomes included 90-day postoperative complications and rates of capsular contracture within a two-year follow-up. RESULTS: A total of 439 patients receiving IBBR using ADM were identified. Of those, 215 patients (367 breasts) had full chart reviews. Mastectomy type preceding ADM use differed significantly (p=0.034), though nipple-sparing mastectomy was the most common for all cohorts. While most patients received direct-to-implant reconstruction, significant differences existed between ADM (p<0.0001). Short-term complications, total reconstruction failure, and reoperation within 90-days were comparable. No differences were found for rates of capsular contracture (p=0.385) and explantation (p=0.694). CONCLUSION: This preliminary data demonstrates equivalence in short- and long-term complications between SurgiMend, AlloDerm, and DermACELL. Our findings support further evidence-based use of ADMs.