The use of SERI™ Surgical Scaffolds in direct-to-implant reconstruction after skin-sparing mastectomy: A retrospective study on surgical outcomes and a systematic review of current literature

Publication date: Available online 15 February 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Arjen A.W.M. van Turnhout, Charlotte J.J. Franke, Eline J.C. Vriens-Nieuwenhuis, Wouter B. van der Sluis
IntroductionLittle is reported on surgical outcomes of SERI Surgical Scaffold, a bioresorbable silk-derived surgical scaffold, developed to provide soft-tissue support and repair, in implant/expander breast reconstruction.MethodsA retrospective chart study was conducted of all patients who underwent direct-to-implant reconstruction with a SERI surgical scaffold after skin-sparing mastectomy, recording surgical characteristics, perioperative complications and reoperations. A systematic literature review was conducted focusing on preclinical and clinical studies reporting on use of SERI in breast surgery.ResultsA total of 16 patients (22 breasts) were identified (mean age at surgery was 47 ± 6.8 years, mean BMI 23.1 ± 3.1 kg/m², mean ablation weight 530 ± 221 g, median clinical follow-up time 27 months (range 25–37)). There were no intraoperative complications. Postoperative bleeding, that required reoperation occurred in one (5%) breast, postoperative seroma in 10 (45%) and surgical site infection in 2 (9%). Scaffold-related complications occurred in 3 (14%) breasts, comprising lack of scaffold integration in all, resulting in skin ulceration in 2 and the scaffold lying free in the breast pocket surrounded with seroma in one. Nine articles were selected and reviewed from the 170 identified.DiscussionThe role of silk-derived scaffolds in breast reconstruction is yet to be determined. Though first reports have shown promising results, our and others results suggest that scaffold-related complications, such as lack of scaffold integration, may occur more frequently than previously described. Further research is necessary to determine possible (dis)advantages of the scaffold in specific patient groups.