A human-derived acellular dermal matrix for breast reconstruction: The first European experience

The growing diffusion of direct-to-implant breast reconstruction (DTI-BR) following mastectomy for breast cancer (BC) is largely related to the introduction and increasing use in clinical practice of acellular dermal matrices (ADMs). Human-derived ADMs (H-ADMs) showed optimal outcomes in breast reconstruction and a better integration in the host tissues when compared with animal-derived products; according to the European legislation, H-ADMs are considered “human products,” subjected to the European laws on transplantation, and not “medical devices.” The Skin Bank of the Bufalini Hospital (Cesena, Italy) in 2009 obtained from the Italian National Transplant Center and National Health Institute the approval for the production and distribution of a new human cadaver-donor-derived ADM (named with the Italian acronym, MODA – Matrice Omologa Dermica Acellulata – Homologous Decellularized Dermal Matrix); in 2015 we started to use MODA in breast reconstructions following mastectomies for BC. To our knowledge, this is the first European experience about the routine use of H-ADMs in breast reconstruction surgery reported.