Acellular Collagen Matrix versus Autologous Breast Reconstruction: What do the Patients Prefer!
Lay In Lim and Amar Deshpande
World Journal of Surgical Medical and Radiation Oncology 2014, 3:12
Acellular collagenl matrix (ACM) is getting more popular and well established in recent years in breast reconstruction where it is used to achieve implant cover and produce a better outcome. There are different types of tissue matrix which are made from different materials such as porcine dermis (Strattice tm ), foetal bovine dermis (Surgimend tm), etc. Another well-known method of breast reconstruction is using autologous tissue such as Lattisimus Dorsi flap or Transverse Rectus Abdominis Myocutaneous flap.
Aims: We are looking into the outcome of breast reconstruction using ACM versus breast reconstruction with autologous tissue. The outcomes include patient satisfaction, post-operative psychosocial, sexual and physical well-being, complications after breast reconstruction, information given and evaluation from patients on surgeons and medical team’s care towards patients.
This study is carried out as a retrospective study on a single institution. Patients who have had breast reconstruction using ACM and autologous tissue were randomly identified from the electronic patient records from year 2009 to 2013. Questionnaires were posted to patients and data were analysed. Breast Q questionnaire was used for this study. Breast Q™ is a validated and copyrighted questionnaire designed for researchers to assess a patient’s perspective before and after their breast reconstruction. The Breast Q™ scoring system was used to analyse our data. Each cohort received 18 responses, therefore the total sample size is 36 patients.
On average, patients have scored more than 60 out of 100 on all the aspects except on sexual well-being where the mean score for patients who has had ACM was 49 and for the patients who had autologous reconstruction was 59. Patients with ACM scored slightly higher score as compared to patients with autologous reconstruction in terms of physical well-being, satisfaction with surgeons and overall care whereas patients with autologous reconstruction scored slightly higher scores as compared to patients with ACM in terms of satisfaction with breasts, outcomes, psychosocial well-being, social well-being and satisfaction with information. In the result analysis, we also looked into median for each categories and used Mann Whitney U test as our statistical analysis. The value for U statistic was 21. For 5% two-tailed level, critical value of U is 13. As calculated U> U critical, and the p value is 0.247996, we accept the null hypothesis that the two groups of data are not different.
There was no significant difference in terms of outcomes in between the 2 groups of patients. Through this study, it is suggested that breast reconstructions using ACM and autologous tissue are safe to be used and patients satisfaction s are good.