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A Study of the Use of Acellular Dermal Matrix for Breast Reconstruction

Phase 3
Active, not recruiting
Conditions
Breast Cancer
Interventions
Procedure: Prepectoral Breast Reconstruction without Acellular Dermal Matrix (ADM)
Procedure: Prepectoral Breast Reconstruction with Acellular Dermal Matrix (ADM)
Registration Number
NCT05316324
Lead Sponsor
Memorial Sloan Kettering Cancer Center
Brief Summary

The researchers are doing this study to look at the number of complications that occur immediately after prepectoral breast reconstruction when Acellular Dermal Matrix (ADM) is used compared to when ADM is not used. These complications include infections, the need for Tissue Expander (TE) or implant removal, and other conditions that lead to additional surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
353
Inclusion Criteria
  • Females aged 21-60 years
  • Planning to undergo unilateral or bilateral mastectomy, prophylactically or to treat breast cancer
  • Planning to undergo immediate two-stage prosthetic breast reconstruction with TE placement as the first stage
  • Planning to undergo nipple-sparing or skin-sparing mastectomy
  • Adequate mastectomy skin perfusion or adequate perfusion but nonviable mastectomy skin that can be excised (≤4 cm) at the defect margins with otherwise adequate perfusion
  • Intraoperative confirmation of prepectoral plane viability by operating physician
Exclusion Criteria
  • History of radiotherapy to the operative breast
  • Current smoker
  • Non-English speaking patients
  • Planning to undergo direct-to-implant reconstruction
  • Prior sternotomy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Prepectoral Breast Reconstruction without ADMPrepectoral Breast Reconstruction without Acellular Dermal Matrix (ADM)-
Prepectoral Breast Reconstruction with ADMPrepectoral Breast Reconstruction with Acellular Dermal Matrix (ADM)-
Primary Outcome Measures
NameTimeMethod
Percentage of patients who experience major complications90 days

Listed below are definitions for 90-day major complications for TEs (i.e., infection, explantation, and reoperation for any cause, including mastectomy flap necrosis):

* Infection defined as:

* Any event requiring the restart of antibiotics (oral or intravenous) after completion of initial perioperative antibiotics

* Admission to the hospital for signs and symptoms of cellulitis (redness on breast mound) requiring antibiotics

* Purulent drainage from the surgical site or incision

* Explantation defined as the need for removal of a TE for any cause

* Reoperation defined as skin excision performed in either the clinic or the operating room for mastectomy skin flap necrosis, surgical incision dehiscence, pending skin breakdown or another surgical complication

Secondary Outcome Measures
NameTimeMethod
Estimate rates of minor complications (specifically seroma)90 days

Minor complication for (Tissue Expanders) TEs are defined as:

o Seroma: Clinically significant noninfected fluid collection requiring either needle aspiration or drain replacement

Trial Locations

Locations (2)

Memorial Sloan Kettering Cancer Center (All Protocol Activities)

🇺🇸

New York, New York, United States

Memorial Sloan Kettering Nassau (Limited Protocol Activities)

🇺🇸

Rockville Centre, New York, United States

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