{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:04:34Z","timestamp":1780095874999,"version":"3.54.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"DOF","award":["IIT"],"award-info":[{"award-number":["IIT"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Conventional detergent-based decellularization can disrupt the extracellular matrix (ECM) structure and denature proteins. Supercritical carbon dioxide (scCO2) processing offers a simplified manufacturing process (&lt;2\u2009hours), minimal protein denaturation, and excellent ECM preservation. This study aimed to evaluate the clinical outcomes of scCO2 processing acellular dermal matrix (ADM) compared with conventional detergent-processed ADM.<\/jats:p>\n                  <jats:p>This prospective observational study enrolled patients undergoing immediate implant-based breast reconstruction with scCO2-processed ADM (n\u2009=\u200950) and compared outcomes with a retrospective cohort receiving conventional detergent-processed human ADM (n\u2009=\u200950). Patient demographics, comorbidities, and treatment variables were collected. Postoperative complications and BREAST-Q\u2013assessed patient-reported outcomes were analyzed.<\/jats:p>\n                  <jats:p>The groups were comparable in age (45.0\u2009\u00b1\u200910.4 years vs. 46.8\u2009\u00b1\u20099.4 years, p\u2009=\u20090.362), body mass index (median: 21.5\u2009kg\/m2 vs. 22.7\u2009kg\/m2, p\u2009=\u20090.558), comorbidities, and oncologic characteristics. Rates of skin necrosis (2% vs. 0%), nipple\u2013areolar complex necrosis (2% vs. 2%), hematoma (4% vs. 4%), seroma (6% vs. 0%), infection (6% vs. 0%), capsular contracture (8% vs. 12%), implant failure (0% vs. 0%), implant change (2% vs. 2%), and reoperation (2% vs. 2%) did not differ significantly between groups. BREAST-Q questionnaires revealed no significant differences in patient-reported outcomes.<\/jats:p>\n                  <jats:p>scCO2-processed ADM demonstrated safety and patient-reported outcomes equivalent to established detergent-based ADMs. Given its eco-friendly, protein-preserving manufacturing process, scCO2-processed ADM represents a safe and effective alternative for implant-based breast reconstruction. Long-term follow-up studies are warranted.<\/jats:p>","DOI":"10.1055\/a-2863-3696","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T22:52:38Z","timestamp":1777330358000},"page":"211-216","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Observational Study of Supercritical Carbon Dioxide-Processed Acellular Dermal Matrix in Implant-Based Breast Reconstruction"],"prefix":"10.1055","volume":"53","clinical-trial-number":[{"clinical-trial-number":"kct0008722","registry":"10.18810\/cris"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0096-7401","authenticated-orcid":false,"given":"Hyung Bae","family":"Kim","sequence":"additional","affiliation":[{"name":"University of Ulsan, Republic of Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery, Asan Medical Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6658-751X","authenticated-orcid":false,"given":"Ji Hye","family":"Oh","sequence":"additional","affiliation":[{"name":"University of Ulsan, Republic of Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery, Asan Medical Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9736-2172","authenticated-orcid":false,"given":"Seong Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"University of Ulsan, Republic of Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery, Asan Medical Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3229-2012","authenticated-orcid":false,"given":"Jin Sup","family":"Eom","sequence":"additional","affiliation":[{"name":"University of Ulsan, Republic of Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery, Asan Medical Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7072-9882","authenticated-orcid":false,"given":"Hyun Ho","family":"Han","sequence":"additional","affiliation":[{"name":"University of Ulsan, Republic of Korea","department":["College of Medicine, Department of Plastic and Reconstructive Surgery, Asan Medical Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"7S","DOI":"10.1097\/PRS.0000000000003941","article-title":"Current trends in postmastectomy breast reconstruction","volume":"140","author":"H Panchal","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"649e","DOI":"10.1097\/PRS.0000000000011117","article-title":"Acellular dermal matrix without basement membrane in immediate prepectoral breast reconstruction: a randomized controlled trial","volume":"154","author":"W Y Han","year":"2024","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/PRS.0b013e3182729cde","article-title":"A paradigm shift in U.S. breast reconstruction: increasing implant rates","volume":"131","author":"C R Albornoz","year":"2013","journal-title":"Plast Reconstr Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1407797","DOI":"10.3389\/fbioe.2024.1407797","article-title":"Assessment of inflammatory suppression and fibroblast infiltration in tissue remodelling by supercritical CO2 acellular dermal matrix (scADM) utilizing Sprague Dawley models","volume":"12","author":"N Ngan Giang","year":"2024","journal-title":"Front Bioeng Biotechnol"},{"key":"ref5","series-title":"Methods in Cell Biology","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/bs.mcb.2019.10.012","volume-title":"Chapter 4 - Use of supercritical CO2 in soft tissue decellularization","volume":"Vol. 157","author":"B Topuz","year":"2020"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1002\/term.3359","article-title":"Effective decellularization of human skin tissue for regenerative medicine by supercritical carbon dioxide technique","volume":"16","author":"N N Giang","year":"2022","journal-title":"J Tissue Eng Regen Med"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/229255031202000201","article-title":"Acellular dermal matrices: Use in reconstructive and aesthetic breast surgery","volume":"20","author":"S A Macadam","year":"2012","journal-title":"Can J Plast Surg"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1055\/s-0039-1696986","article-title":"Evidence for the use of acellular dermal matrix in implant-based breast reconstruction","volume":"33","author":"P R Gravina","year":"2019","journal-title":"Semin Plast Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1133806","DOI":"10.3389\/frtra.2023.1133806","article-title":"Acellular dermal matrix in reconstructive surgery: applications, benefits, and cost","volume":"2","author":"F Mohammadyari","year":"2023","journal-title":"Front Transplant"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"3435","DOI":"10.3390\/app10103435","article-title":"Decellularized scaffolds for skin repair and regeneration","volume":"10","author":"M Dussoyer","year":"2020","journal-title":"Appl Sci (Basel)"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s10561-014-9467-4","article-title":"Decellularization of human dermis using non-denaturing anionic detergent and endonuclease: a review","volume":"16","author":"M A Moore","year":"2015","journal-title":"Cell Tissue Bank"},{"key":"ref12","first-page":"98","article-title":"Decellularized extracellular matrix biomaterials for regenerative therapies: Advances, challenges and clinical prospects","volume":"32","author":"A A Golebiowska","year":"2023","journal-title":"Bioact Mater"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0896-8446(03)00029-9","article-title":"Supercritical and near-critical CO2 in green chemical synthesis and processing","volume":"28","author":"E J Beckman","year":"2004","journal-title":"J Supercrit Fluids"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1002\/jctb.1899","article-title":"Cell removal with supercritical carbon dioxide for acellular artificial tissue","volume":"83","author":"K Sawada","year":"2008","journal-title":"J Chem Technol Biotechnol"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1039\/D1MH01720A","article-title":"Contributions of supercritical fluid technology for advancing decellularization and postprocessing of viable biological materials","volume":"9","author":"M M Duarte","year":"2022","journal-title":"Mater Horiz"},{"issue":"12","key":"ref16","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3390\/ijms26125715","article-title":"Supercritical carbon dioxide-processed acellular dermal matrix patch for enhanced wound healing","volume":"26","author":"X Zhang","year":"2025","journal-title":"Int J Mol Sci"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"354","DOI":"10.7150\/ijms.41155","article-title":"Supercritical carbon dioxide-decellularized porcine acellular dermal matrix combined with autologous adipose-derived stem cells: its role in accelerated diabetic wound healing","volume":"17","author":"P R Chou","year":"2020","journal-title":"Int J Med Sci"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2863-3696.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:48:16Z","timestamp":1780094896000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2863-3696"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":17,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2863-3696","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4,27]]},"published":{"date-parts":[[2026,4,27]]}}}