Abdominal wall repair using human acellular dermis.
BACKGROUND
The surgical repair of abdominal wall defects that cannot be closed primarily in contaminated fields is a difficult problem. The use of nonabsorbable synthetic materials usually is contraindicated in this setting because of the risk for colonization and chronic infection of the mesh. In this study we sought to determine the safety and efficacy of implanted human acellular dermal graft for abdominal wall reconstruction.


METHODS
The records of all patients (n = 20) who underwent a repair of an abdominal wall defect with human acellular dermal graft at a Veteran Affairs hospital were reviewed retrospectively. Patient demographics, complications, and hernia recurrence were recorded.


RESULTS
There were 15 perioperative complications in 11 patients: 6 graft dehiscences, 1 evisceration, 2 postoperative intra-abdominal bleeds, 5 bacterial graft infections, and 1 death. Patients with heart disease, American Society of Anesthesiologists classification of 4, and/or dirty wounds were more likely to have perioperative complications. The median follow-up period was 9.4 months (range, 2-16 mo), during which 6 hernia recurrences were noted.


CONCLUSIONS
Human acellular dermis use is safe in abdominal wall reconstructions in contaminated surgical wounds.
Bellows
Charles F
CF
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Michael E. DeBakey Veterans Affairs Hospital, m/c 112, 2002 Holcombe Blvd., Houston, TX 77030, USA. cbellows@bcm.tmc.edu
Albo
Daniel
D
Berger
David H
DH
Awad
Samir S
SS
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D015331:Cohort Studies; D003094:Collagen; D046449:Hernia, Abdominal / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome
C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen