The use of Cortiva® Allograft Dermis in two-staged breast reconstruction: A matched-comparison and cost analyses study.

Abstract

Acellular dermal matrices (ADM) are an adjunct in implant-based breast reconstruction. While clinical outcomes have generally been equivocal between brands, a cost analysis between these brands has yet to be conducted. This study reports a single, academic institution's experience with 2 ADM brands in breast reconstruction and provides data on clinical and financial outcomes. A retrospective chart review of patients who underwent two-staged breast reconstruction with Cortiva® Allograft Dermis ® was matched with a cohort who received AlloDerm RTU. Comparison of clinical outcomes, such as complications and revision surgeries, in addition to a cost analysis was completed. The study cohort included 24 patients who received Cortiva® and 24 patients who received AlloDerm. There were no statistical differences in demographics or breast-specific characteristics between the cohorts. Major complications were not statistically increased with Cortiva® use [Hazard Ratio 1.78 (0.421-7.66)], but the rate of revision following second-stage reconstruction trended toward significance with Cortiva® use [3.41 (0.99-11.80), p=0.05]. The material base cost and total cost following surgeries were lower for Cortiva® (44% of the AlloDerm costs) but the incremental costs did not display significant difference secondary to comparable complication and revision rates. The use of Cortiva® Allograft Dermis was shown to have a decreased cost in base material and total cost associated with surgery while also displaying comparable clinical outcomes and complication rate. Additional studies examining patient-reported outcomes would complement the growing literature comparing ADM brands.