Acellular bovine pericardium in implant-based breast reconstruction: A systematic review of the literature

Abstract

Background

The use of bovine acellular pericardium as a pectoral extender is a relatively newer biologic in prosthetic breast reconstruction. Fewer studies with smaller sample sizes have been conducted on the outcome and complications of its use lacking comprehensive data. We therefore reviewed the published literature and conducted a systematic review to summarise both aesthetic benefits and reported complications.

Methods

A literature search of electronic databases (Medline/PubMed and Embase) between January 2010 and July 2016 was conducted. The search terms breast reconstruction, Veritas®, bovine pericardial patch, bovine pericardium and acellular collagen matrix were used. Inclusion criteria were restricted to articles containing data on bovine pericardial collagen matrix used in breast reconstruction either immediate or delayed. Graph Pad Prism statistical software was used for summarising and depicting results.

Results

Data from 87 patients included in five articles which met the inclusion criteria were collated. In total, 135 procedures were performed using Veritas®. Sixty-six patients’ procedures were immediate reconstruction, 57 procedures were delayed reconstruction, and seven patients lack the details of the type of reconstruction. Complications were reported for 80 patients seroma was noticed in 12 patients (15%); skin necrosis was noticed in 5 patients (6.25%); infection was noticed in 6 patients (7.5%); and haematoma was noticed in 3 patients (3.75%). No patient presented with a capsular contracture. In total, 9 patients have received radiotherapy.

Conclusion

Use of acellular bovine pericardium is safe according to the results published in the literature so far. Randomised controlled study comparing acellular dermal matrix with acellular bovine pericardium using a similar group of patients with minimal or no inter surgeon variance are warranted to compare and contrast outcomes.

Level of Evidence: Not ratable

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