A comparative analysis of cryopreserved versus prehydrated human acellular dermal matrices in tissue expander breast reconstruction

Ann Plast Surg. 2013 Jun;70(6):632-5. doi: 10.1097/SAP.0b013e318250f0b4.


Background: The use of human acellular dermal matrices (HADMs) in breast reconstruction has become routine practice for many reconstructive surgeons. Comparative studies between 2 more common iterations of human acellular dermis are scarce. Our study evaluated reconstructive outcomes of cryopreserved and prehydrated HADMs in comparative fashion.

Methods: This study is a retrospective review of 369 consecutive tissue expander breast reconstructions performed by 2 board-certified plastic surgeons whose practice focuses on breast reconstruction. Data were collected independently by 2 reviewers, and a comparative analysis for statistical significance of outcomes was performed using the Fisher exact test, 2-tailed independent t tests, and regression analysis where appropriate.

Results: Over a 5-year period, 255 patients (369 breasts) underwent breast reconstruction utilizing either cryopreserved or prehydrated HADM. Of the total, 136 breasts received cryopreserved and 233 breasts received prehydrated HADMs. The total complication rates for cryopreserved and prehydrated HADMs were 19.1% and 19.3% (P = 1.0), respectively. Additional complication rates were calculated for flap necrosis (8.1% vs 9.0%, P = 0.849), infection requiring intravenous antibiotics (10.3% vs 5.2%, P = 0.09), hematoma (2.9% vs 1.3%, P = 0.431), seroma (2.2% vs 1.0%, P = 1.0), expander exposure/dehiscence (5.9% vs 6.4%, P = 1.0), and number of breasts requiring autologous reconstruction after a complication (4.4% vs 6.4%, P = 0.491). On regression analysis, HADM type was not an independent risk factor for any complication subtype.

Conclusions: The results of this study suggest that there are no significant differences in complication rates between cryopreserved and prehydrated HADMs.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acellular Dermis*
  • Adult
  • Collagen*
  • Cryopreservation*
  • Female
  • Humans
  • Mammaplasty / instrumentation
  • Mammaplasty / methods*
  • Mastectomy
  • Middle Aged
  • Outcome Assessment, Health Care
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • Specimen Handling / methods*
  • Tissue Expansion*


  • Alloderm
  • FlexHD
  • Collagen