Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic review

Background: Alloplastic breast reconstruction continues to be the most prevalent breast reconstruction performed in the United States. Plastic surgeons are challenged to recreate the breast footprint after the ablative surgeon's mastectomy. Mesh augmentation has emerged as a valuable tool in co...

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Main Authors: Allisa Barber, Aishu Ramamurthi, Madeline Ebert, Nelson Rodriguez-Unda
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JPRAS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352587825000713
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author Allisa Barber
Aishu Ramamurthi
Madeline Ebert
Nelson Rodriguez-Unda
author_facet Allisa Barber
Aishu Ramamurthi
Madeline Ebert
Nelson Rodriguez-Unda
author_sort Allisa Barber
collection DOAJ
description Background: Alloplastic breast reconstruction continues to be the most prevalent breast reconstruction performed in the United States. Plastic surgeons are challenged to recreate the breast footprint after the ablative surgeon's mastectomy. Mesh augmentation has emerged as a valuable tool in controlling implant migration. Several soft tissue support breast meshes have been introduced, each characterized by a different risk profile, cost, and associated complications. Objectives: This manuscript presents a comprehensive systematic review, with updated data over the last decade, of the use of a resorbable and less costly VICRYL (Ethicon, Somerville, NJ, USA) mesh in breast reconstruction after mastectomy. Methods: The authors conducted a systematic review of the use of VICRYL mesh in breast reconstruction using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors queried five databases. Data was collected using a standardized form and underwent review using set inclusion and exclusion criteria. The primary outcome variable was reconstructive failure, with secondary outcomes including seroma, hematoma, skin necrosis, and infection. Results: A total of 693 articles were found after the multi database search. Forty articles met inclusion criteria. Following full text review, six articles analyzing 511patients were included. VICRYL mesh was utilized in 711 breast reconstructions, of which 5% were complicated by reconstructive failure (confidence interval (CI): 4.75–5.25%); 1.6% by seroma (CI: 1.53–1.67%); 3.33% by infection (CI: 3.14–3.52%); 1.83% by hematoma (CI: 1.71–1.95%); and 6.33% by skin necrosis (CI: 6.03–6.63%). Conclusion: VICRYL mesh repeatedly demonstrates low reconstructive failure in breast reconstruction with an acceptable complication profile.
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spelling doaj-art-04d710eaf06e4739a8dfae226dec8f9e2025-08-20T01:53:27ZengElsevierJPRAS Open2352-58782025-06-014435436310.1016/j.jpra.2025.04.002Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic reviewAllisa Barber0Aishu Ramamurthi1Madeline Ebert2Nelson Rodriguez-Unda3Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53212Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53212Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53212Corresponding author.; Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53212Background: Alloplastic breast reconstruction continues to be the most prevalent breast reconstruction performed in the United States. Plastic surgeons are challenged to recreate the breast footprint after the ablative surgeon's mastectomy. Mesh augmentation has emerged as a valuable tool in controlling implant migration. Several soft tissue support breast meshes have been introduced, each characterized by a different risk profile, cost, and associated complications. Objectives: This manuscript presents a comprehensive systematic review, with updated data over the last decade, of the use of a resorbable and less costly VICRYL (Ethicon, Somerville, NJ, USA) mesh in breast reconstruction after mastectomy. Methods: The authors conducted a systematic review of the use of VICRYL mesh in breast reconstruction using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors queried five databases. Data was collected using a standardized form and underwent review using set inclusion and exclusion criteria. The primary outcome variable was reconstructive failure, with secondary outcomes including seroma, hematoma, skin necrosis, and infection. Results: A total of 693 articles were found after the multi database search. Forty articles met inclusion criteria. Following full text review, six articles analyzing 511patients were included. VICRYL mesh was utilized in 711 breast reconstructions, of which 5% were complicated by reconstructive failure (confidence interval (CI): 4.75–5.25%); 1.6% by seroma (CI: 1.53–1.67%); 3.33% by infection (CI: 3.14–3.52%); 1.83% by hematoma (CI: 1.71–1.95%); and 6.33% by skin necrosis (CI: 6.03–6.63%). Conclusion: VICRYL mesh repeatedly demonstrates low reconstructive failure in breast reconstruction with an acceptable complication profile.http://www.sciencedirect.com/science/article/pii/S2352587825000713VICRYL meshBreast reconstructionDirect to implantAcellular dermal matrix
spellingShingle Allisa Barber
Aishu Ramamurthi
Madeline Ebert
Nelson Rodriguez-Unda
Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic review
JPRAS Open
VICRYL mesh
Breast reconstruction
Direct to implant
Acellular dermal matrix
title Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic review
title_full Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic review
title_fullStr Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic review
title_full_unstemmed Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic review
title_short Revisiting low complications of VICRYL mesh in breast reconstruction: Insights from an updated systematic review
title_sort revisiting low complications of vicryl mesh in breast reconstruction insights from an updated systematic review
topic VICRYL mesh
Breast reconstruction
Direct to implant
Acellular dermal matrix
url http://www.sciencedirect.com/science/article/pii/S2352587825000713
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