SERI Surgical Scaffold in 2-Stage Breast Reconstruction: 2-Year Data from a Prospective, Multicenter Trial

Background: Soft-tissue support devices are used during breast reconstruction. This study investigated long-term clinical data following SERI Surgical Scaffold (SERI) implantation, a bioresorbable, silk-derived scaffold for soft-tissue support. Methods: This was a prospective, multicenter study in 103 subjects who received SERI during stage 1 of 2-stage breast reconstruction with subpectoral tissue expander placement (Natrelle Style 133V; Allergan plc, Dublin, Ireland) followed by subpectoral breast implant placement. Investigator satisfaction (11-point scale: 0, very dissatisfied and 10, very satisfied) at 6 months was the primary endpoint. Ease of use, satisfaction, scaffold palpability/visibility, breast anatomy measurements via 3D images, SERI integration, histology, and safety were also assessed through 2 years after stage 1 surgery. Results: Analyses were performed on the per-protocol population (103 subjects; 161 breasts) with no protocol deviations that could affect outcomes. Ease of use and subject and investigator satisfaction with SERI were high throughout 2 years. Breast anatomy measurements with 3D images demonstrated long-term soft-tissue stability of the lower breast mound. Key complication rates per breast were tissue/skin necrosis and wrinkling/rippling (8.1% each) and seroma, wound dehiscence, and breast redness (5.0% each). Over 2 years, 4 breasts in 4 subjects underwent reoperation with explantation of any device; 2 breasts required SERI explantation. SERI was retained in 98.8% of breasts (159/161) at 2 years. Conclusions: SERI was associated with high and consistent levels of investigator and subject satisfaction and demonstrated soft-tissue stability in the lower breast through 2 years. SERI provides a safe, long-term benefit for soft-tissue support in 2-stage breast reconstruction.

[1]  K. Ranganathan,et al.  Use of Acellular Dermal Matrix in Postmastectomy Breast Reconstruction: Are All Acellular Dermal Matrices Created Equal? , 2015, Plastic and reconstructive surgery.

[2]  N. Fine,et al.  SERI Surgical Scaffold, Prospective Clinical Trial of a Silk-Derived Biological Scaffold in Two-Stage Breast Reconstruction: 1-Year Data , 2015, Plastic and reconstructive surgery.

[3]  L. Neumayer,et al.  The BREASTrial: Stage I. Outcomes from the Time of Tissue Expander and Acellular Dermal Matrix Placement to Definitive Reconstruction , 2015, Plastic and reconstructive surgery.

[4]  G. Altman,et al.  An Evaluation of SERI Surgical Scaffold for Soft-Tissue Support and Repair in an Ovine Model of Two-Stage Breast Reconstruction , 2014, Plastic and reconstructive surgery.

[5]  M. Clemens,et al.  A 12-month Survey of Early Use and Surgeon Satisfaction with a New Highly Purified Silk Matrix: SERI Surgical Scaffold , 2014, Plastic and reconstructive surgery. Global open.

[6]  K. Hajifathalian,et al.  A meta-analysis of human acellular dermis and submuscular tissue expander breast reconstruction. , 2012, Plastic and reconstructive surgery.

[7]  Ahva Shahabi,et al.  A Systematic Review and Meta-Analysis of Complications Associated With Acellular Dermal Matrix-Assisted Breast Reconstruction , 2012, Annals of plastic surgery.

[8]  J. Yueh,et al.  Complications Following Expander/Implant Breast Reconstruction Utilizing Acellular Dermal Matrix: A Systematic Review and Meta-Analysis , 2011, Eplasty.

[9]  M. Newman,et al.  The True Incidence of Near-Term Postoperative Complications in Prosthetic Breast Reconstruction Utilizing Human Acellular Dermal Matrices: A Meta-Analysis , 2011, Aesthetic Plastic Surgery.

[10]  M. Newman,et al.  AlloDerm performance in the setting of prosthetic breast surgery, infection, and irradiation. , 2010, Plastic and reconstructive surgery.

[11]  S. Lipsitz,et al.  Implant-Based Breast Reconstruction Using Acellular Dermal Matrix and the Risk of Postoperative Complications , 2010, Plastic and reconstructive surgery.

[12]  H. Langstein,et al.  Acellular Dermis–Assisted Prosthetic Breast Reconstruction versus Complete Submuscular Coverage: A Head-to-Head Comparison of Outcomes , 2009, Plastic and reconstructive surgery.

[13]  S. Leinster,et al.  Systematic review of studies of patients' satisfaction with breast reconstruction after mastectomy. , 2007, Breast.

[14]  G. Altman,et al.  Biological and biomechanical assessment of a long-term bioresorbable silk-derived surgical mesh in an abdominal body wall defect model , 2007, Hernia.

[15]  E. Karacaoğlu,et al.  Implant-Based Breast Reconstruction with Allograft , 2007, Plastic and reconstructive surgery.

[16]  J. Bostwick Reconstruction after mastectomy. , 1990, The Surgical clinics of North America.

[17]  S. Miller The Influence of AlloDerm on Expander Dynamics and Complications in the Setting of Immediate Tissue Expander/Implant Reconstruction: A Matched-Cohort Study , 2009 .