Table 3. Cosmetic outcome studies – ADM versus non-ADM cohort.
| Author | Cohorts compared | Variables compared at baseline | Assessors/method used | Follow-up period/time of assessment | Method of evaluation | Results |
|---|---|---|---|---|---|---|
| Ibrahim et al [28], 2015 | ADM (Alloderm or Surgimend) n = 18 patients Non-ADM n = 20 patients |
Yes NSD | Panel assessment of pre-/post-operative photographs by five plastic surgeons not directly involved in care and blinded | Six months to seven years (1.7 years) Not compared between groups | Scored using validated subscales for volume; contour; placement of implant; scars; lower pole projection; IMF definition | ADM cohort scored statistically significantly higher in terms of overall cosmetic outcome and for subscales for contour and implant placement |
| Forsberg et al [29], 2014 | ADM (type not specified) n = 58 reconstructions Non-ADM n = 125 reconstructions |
Yes – significantly more delayed reconstructions in non-ADM cohort | Panel assessment of post-operative photographs; 18 blinded assessors (six plastic surgeons; six trainees; six medical students) | ADM: 25 months Non-ADM: 34 months Significant difference p = 0.005 |
Scored using validated subscales for contour; symmetry of shape; symmetry of size; position and overall outcome | ADM cohort received higher scores for all parameters in each group of assessors. Difference reached significance for majority |
| Nguyen et al [31], 2012 | ADM (type not specified) n = 53 patients Non-ADM n = 58 |
Yes – significantly higher BMI in ADM cohort | Panel assessment of post-operative photographs; three plastic surgeons not involved in care; blinded | Not specified, although photographs taken at least 90 days following second-stage procedure | Scored using validated subscales for volume; contour; placement of implant; scars; lower pole projection; IMF definition | ADM cohort scored statistically significantly higher in terms of overall cosmetic outcome and for subscales for volume, IMF definition and implant placement |
| Vardanian et al [30], 2011 | ADM (Alloderm) n = 208 reconstructions Non-ADM – partial (n = 119) and total (n = 10) sub-muscular |
Yes NSD | Panel assessment of post-operative photographs; four blinded assessors – surgeon, secretary and two medical students | Not stated – all post-implant exchange | Four-point Harris scale for overall aesthetic outcome and IMF placement (1 – poor; 2 – fair; 3 – good; 4 – excellent) | Score for both overall aesthetic outcome and IMF placement significantly higher in ADM cohort |
NSD: no significant difference.