{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:28:55Z","timestamp":1786494535872,"version":"build-2736575974"},"reference-count":50,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Polydioxanone (PDS) mesh is an emerging technology for prosthetic breast reconstruction. However, there is a paucity of data on its safety and efficacy in primary breast reconstruction.<\/jats:p>\n                  <jats:p>Demographic and outcomes measures from consecutive, immediate prosthetic breast reconstructions using PDS or acellular dermal matrix (ADM) from a single surgeon were evaluated on a per-breast basis between 2013 and 2023. Propensity matching based on demographic variables was conducted. Binary logistic regression analyses were performed to assess the impact of the mesh.<\/jats:p>\n                  <jats:p>A total of 796 breast reconstructions were identified, and propensity matching yielded 192 ADM and 48 PDS mesh reconstructions. There was no significant difference with respect to age, American Society of Anesthesiologists (ASA) status, smoking history, diabetes, mastectomy indication, radiation, chemotherapy, expander plane, and mastectomy type between propensity matched cohorts. Body mass index (BMI) varied by 2.1 points (ADM: 25.8 vs. PDS: 23.7, p\u2009=\u20090.01). Mean follow-up time was 13.5\u2009\u00b1\u20092.7 months. The propensity-matched PDS mesh cohort had lower rates of any complication (ADM: 23.9% vs. PDS mesh: 4.2%, p\u2009=\u20090.003), seroma (ADM: 11.4% vs. PDS mesh: 0%, p\u2009=\u20090.01), expander exposure (ADM: 12.5% vs. PDS mesh: 0%, p\u2009=\u20090.01), complication-associated expander removal (ADM: 9.9% vs. PDS mesh: 0%, p\u2009=\u20090.02), and mastectomy flap necrosis (ADM: 14.0% vs. PDS mesh: 4.2%, p\u2009=\u20090.05). PDS mesh, compared to ADM, was independently associated with decreased risk of any complication (OR: 0.443, p\u2009=\u20090.02), seroma (odds ratio [OR]: 0.456, p\u2009=\u20090.03), expander exposure (OR: 0.277, p\u2009=\u20090.03), complication-associated expander removal (OR: 0.211, p\u2009=\u20090.02), and mastectomy flap necrosis (OR: 0.12, p\u2009=\u20090.04).<\/jats:p>\n                  <jats:p>PDS mesh is an alternative to ADM in primary prosthetic breast reconstruction. Rates of complication\u2014including infection, seroma, and explantation\u2014suggest an acceptable safety profile relative to ADM.<\/jats:p>","DOI":"10.1055\/a-2850-0163","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T23:08:12Z","timestamp":1781737692000},"page":"321-330","source":"Crossref","is-referenced-by-count":0,"title":["Early Experience with Synthetic Monofilament Polydioxanone Mesh in Primary Breast Reconstruction: A Propensity Matched Analysis"],"prefix":"10.1055","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8336-7806","authenticated-orcid":false,"given":"Puja","family":"Jagasia","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5794-9449","authenticated-orcid":false,"given":"Reena","family":"Sulkar","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3172-6942","authenticated-orcid":false,"given":"Anna","family":"Whitney","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4333-1884","authenticated-orcid":false,"given":"John Y.S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, United 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Reconstr Surg Glob Open"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1097\/01.prs.0000481102.24444.72","article-title":"Seroma in prosthetic breast reconstruction","volume":"137","author":"S W Jordan","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1016\/j.bjps.2018.06.012","article-title":"Human acellular dermis increases surgical site infection and overall complication profile when compared with submuscular breast reconstruction: An updated meta-analysis incorporating new products\u2730","volume":"71","author":"J M Smith","year":"2018","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/PRS.0b013e3182361fd6","article-title":"A meta-analysis of human acellular dermis and submuscular tissue expander breast reconstruction","volume":"129","author":"J YS Kim","year":"2012","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1097\/SAP.0b013e31823f3cd9","article-title":"A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction","volume":"68","author":"G Ho","year":"2012","journal-title":"Ann Plast Surg"},{"key":"ref11","first-page":"e40","article-title":"Complications following expander\/implant breast reconstruction utilizing acellular dermal matrix: a systematic review and meta-analysis","volume":"11","author":"I C Hoppe","year":"2011","journal-title":"Eplasty"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"e823","DOI":"10.1097\/GOX.0000000000000819","article-title":"Aseptic versus sterile acellular dermal matrices in breast reconstruction: An updated review","volume":"4","author":"D A Lyons","year":"2016","journal-title":"Plast Reconstr Surg Glob 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Brooke","year":"2012","journal-title":"Ann Plast Surg"},{"issue":"S 03","key":"ref22","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1245\/s10434-010-1261-3","article-title":"Complication rates of radiation on tissue expander and autologous tissue breast reconstruction","volume":"17","author":"T Berry","year":"2010","journal-title":"Ann Surg Oncol"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1097\/SAP.0b013e3181dba892","article-title":"The effect of acellular dermal matrix use on complication rates in tissue expander\/implant breast reconstruction","volume":"64","author":"S T Lanier","year":"2010","journal-title":"Ann Plast Surg"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1007\/s00595-020-02175-4","article-title":"Clinical outcomes of patients after nipple-sparing mastectomy and reconstruction based on the expander\/implant technique","volume":"51","author":"U 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Microsurg"},{"issue":"04","key":"ref37","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1097\/01.prs.0000302505.43942.07","article-title":"Histologic analysis of angiogenesis and lymphangiogenesis in acellular human dermis","volume":"121","author":"A K Wong","year":"2008","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref38","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.21873\/invivo.12558","article-title":"Postoperative complications in breast reconstruction with porcine acellular dermis and polypropylene meshes in subpectoral implant placement","volume":"35","author":"K Sch\u00fcler","year":"2021","journal-title":"In Vivo"},{"issue":"01","key":"ref39","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1055\/a-1964-8181","article-title":"Comparing complications of biologic and synthetic mesh in breast reconstruction: A systematic review and network meta-analysis","volume":"50","author":"Y S Choi","year":"2023","journal-title":"Arch Plast 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A review","volume":"38","author":"J W Chen","year":"2022","journal-title":"Arthroscopy"},{"issue":"02","key":"ref41","doi-asserted-by":"crossref","first-page":"e4003","DOI":"10.1097\/GOX.0000000000004003","article-title":"Propensity scoring in plastic surgery research: An analysis and best practice guide","volume":"10","author":"J J Chu","year":"2022","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"41S","DOI":"10.1097\/PRS.0000000000011405","article-title":"DIEP flap versus PAP flap versus LAP flap: A propensity-matched analysis of aesthetic outcomes, complications, and satisfaction","volume":"154","author":"N T Haddock","year":"2024","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref43","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1097\/BSD.0000000000000932","article-title":"Propensity score matching: A statistical method","volume":"33","author":"L T Kane","year":"2020","journal-title":"Clin Spine Surg"},{"issue":"03","key":"ref44","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s00432-022-03973-8","article-title":"A propensity score-matched analysis of breast-conserving surgery plus whole-breast irradiation versus mastectomy in breast cancer","volume":"149","author":"F Magnoni","year":"2023","journal-title":"J Cancer Res Clin Oncol"},{"issue":"03","key":"ref45","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1097\/PRS.0000000000007089","article-title":"The glass ceiling in plastic surgery: A propensity-matched analysis of the gender gap in career advancement","volume":"146","author":"L M Ngaage","year":"2020","journal-title":"Plast Reconstr Surg"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"S242","DOI":"10.1097\/SAP.0000000000003397","article-title":"A propensity score-matched comparison of perioperative outcomes in prepectoral smooth versus textured tissue expander breast reconstruction","volume":"90","author":"K Perez","year":"2023","journal-title":"Ann Plast Surg"},{"issue":"02","key":"ref47","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/SLA.0000000000004416","article-title":"A propensity score-matched analysis of long-term oncologic outcomes after nipple-sparing versus conventional mastectomy for locally advanced breast cancer","volume":"276","author":"Z Y Wu","year":"2022","journal-title":"Ann Surg"},{"issue":"04","key":"ref48","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1097\/PRS.0000000000001569","article-title":"Use of acellular dermal matrix in postmastectomy breast reconstruction: Are all acellular dermal matrices created equal?","volume":"136","author":"K Ranganathan","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref49","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1097\/PRS.0000000000008194","article-title":"Acellular dermal matrix-associated complications in implant-based breast reconstruction: A multicenter, prospective, randomized controlled clinical trial comparing two human tissues","volume":"148","author":"J M Broyles","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"11","key":"ref50","doi-asserted-by":"crossref","first-page":"e569","DOI":"10.1097\/GOX.0000000000000559","article-title":"Incidence of seromas and infections using fenestrated versus nonfenestrated acellular dermal matrix in breast reconstructions","volume":"3","author":"D A Palaia","year":"2015","journal-title":"Plast Reconstr Surg Glob Open"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2850-0163.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T23:53:31Z","timestamp":1786492411000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2850-0163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":50,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2026,8,11]]},"published-print":{"date-parts":[[2026,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2850-0163","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]}}}