无细胞真皮基质（ADM）在胸前重建中经常被使用，但很少有研究探讨ADM类型对并发症风险的影响。本研究确定ADM类型对胸前两阶段异种体重建早期并发症率的影响。我们对2018年至2021年在美国斯隆-凯特琳癌症中心进行ADM支持的即刻胸前两阶段异种体重建的乳房切除术患者进行队列调查。使用的ADM类型包括Alloderm（Allergan，NJ州麦迪逊）、FlexHD（肌肉骨骼移植基金会，NJ州伊迪森市）或SurgiMend（TIE生物科学公司，MA州波士顿）。对每种ADM类型根据组织扩张器（TE）数量确定并发症率。多元逻辑回归用于确定ADM类型在考虑混杂因素后对并发症风险的影响。总共包括726名患者（1054个TE：194个Alloderm、93个FlexHD、767个SurgiMend）。三个队列在乳房切除类型（遗留乳头部分：Alloderm 23.5%、FlexHD 33.3%、SurgiMend 19.1%、p = 0.047）、ADM穿孔（穿孔：Alloderm 94.8%、FlexHD 98.2%、SurgiMend 100%、p < 0.001）和ADM大小（Alloderm：132cm2 [IQR：132-164]，FlexHD：220cm2 [IQR: 220-220]，SurgiMend：200cm2 [IQR：200-200]，p < 0.001）方面存在差异。单变量检验中，ADM类型在积液、感染、暴露、不良位置或TE损失方面不存在差异。此外，在用多元回归调整混杂因素后，没有ADM类型具有更高的TE损失风险。在这个庞大的胸前重建患者队列中，ADM类型对并发症风险没有明显影响。需要进行更多前瞻性研究，以头对头方式评估ADM在胸前重建中的选择。© 2023年作者。由牛津大学出版社代表美学学会出版。版权所有。如需获得许可，请发送电子邮件至journals.permissions@oup.com。

Acellular dermal matrix (ADM) is frequently used in prepectoral breast reconstruction, but few studies have examined the role of ADM type on complication risk.This study determines the impact of ADM type on early complication rates in prepectoral two-stage alloplastic breast reconstruction.We performed a cohort examination of all patients who underwent mastectomy with immediate prepectoral two-stage alloplastic breast reconstruction with ADM support at Memorial Sloan Kettering Cancer Center from 2018-2021. ADM types utilized included Alloderm (Allergan, Madison, NJ), FlexHD (Musculoskeletal Transplant Foundation, Edison, NJ), or SurgiMend (TIE Biosciences, Inc., Boston, MA). Complication rates based on number of tissue expanders (TEs) were determined for each ADM type. Multivariate logistic regression was used to determine the impact of ADM type on complication risk after accounting for confounders.Overall, 726 patients (1054 TEs: 194 Alloderm, 93 FlexHD, 767 SurgiMend) were included. The three cohorts differed in terms of mastectomy type (Nipple-sparing: 23.5% of Alloderm, 33.3% of FlexHD, 19.1% of SurgiMend, p = 0.047), ADM perforation (Perforated: 94.8% of Alloderm, 98.2% of FlexHD, 100% of SurgiMend, p < 0.001), and ADM size (Alloderm: 132cm2 [IQR: 132-164], FlexHD: 220cm2 [IQR: 220220], SurgiMend: 200cm2 [IQR: 200-200], p < 0.001). On univariate examination, no differences existed between ADM types for seroma, infection, exposure, malposition, or TE loss. Additionally, after adjustment for confounders with multivariate regression, no ADM type had higher odds of TE loss.In this large cohort of prepectoral reconstruction patients, ADM type did not significantly affect risk of complications. Additional prospective studies are warranted to evaluate ADM choice for prepectoral breast reconstruction in a head-to-head fashion.© The Author(s) 2023. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.