Safety of GalaFLEX in Prepectoral Breast Reconstruction
Abstract
Background: Prepectoral implant-based breast reconstruction is gaining in popularity. Acellular dermal matrices (ADMs) are an integral part of prepectoral reconstruction. However, large quantities of ADM are required for total implant coverage and the cost of ADMs could be a deterrent to reconstruction. To minimize the cost, the authors have resorted to the use of a bioabsorbable mesh, GalaFLEX, as a replacement to ADMs. The comparative safety of using GalaFLEX in combination with AlloDerm versus AlloDerm alone in prepectoral reconstruction is reported.
Methods: Consecutive patients who underwent immediate, expander-implant, prepectoral breast reconstruction were included in this retrospective study. Patients were stratified into two groups: those who received AlloDerm-GalaFLEX combination versus AlloDerm alone. In AlloDerm-GalaFLEX reconstructions, the lower third of the expander was covered by the AlloDerm while the rest of the expander was covered by GalaFLEX. Complications following reconstruction were compared between the groups.
Results: AlloDerm alone was utilized in 128 patients (249 breasts) and AlloDerm-GalaFLEX in 135 patients (250 breasts). Rate of any complication was 7.6% in the AlloDerm alone group and 6.4% in the AlloDerm-GalaFLEX group. Rate of infection, skin necrosis, seroma, capsular contracture, prosthesis exposure/extrusion, and prosthesis loss were ≤3.0% in the AlloDerm-GalaFLEX group and did not differ significantly from those in the AlloDerm only group.
Conclusions: GalaFLEX bioabsorbable matrix is a less costly alternative to ADMs in two-staged, prepectoral reconstruction with comparable safety outcomes. Further long-term data and clinical experience are needed to better understand the safety of this matrix for use in breast reconstruction.
About the Presenters
Erin O’Rorke
I am a third-year medical student based at the Vancouver campus for my clinical rotations. I grew up in Maple Valley, Washington with my brother and my wonderful parents, a mechanic and a bookkeeper. I am the first in my family to attend college, and earned my Bachelor of Science in molecular, cellular, and developmental biology from the University of Washington before attending medical school at Washington State University. I have an interest in developing a career within breast surgery, specifically reconstruction after procedures such as mastectomies. I am also passionate about increasing female representation in surgery. I love to explore the outdoors in my free time. My most recent trips include Joshua Tree National Park, the Redwood Forest, and Banff, Canada.