Abdominal wall repair using human acellular dermal matrix: a follow-up study.
BACKGROUND
The role of acellular dermal matrix (ADM) in abdominal wall reconstruction (AWR) is unclear. The aim of this study was to review the management, complications, and long-term outcomes of AWR using ADM in a large surgical cohort.


METHODS
Retrospective chart review of patients undergoing AWR using ADM from 2004 to 2007 was performed. Demographic data, comorbidities, complications, and long-term outcomes were collected.


RESULTS
There were 77 cases in 68 patients with mean age of 61.1 +/- 1.4 years. The most common indication was infected fascia (n = 19 [25%]). Wound closure was achieved in 75% of the cases via primary (n = 26 [45%]), secondary intention (n = 17 [29%]), or skin graft (n = 15 [26%]). Nonprimary closure was achieved in 5.7 +/- .7 months. There were 32 perioperative (39%) and 33 long-term (43%) complications. Over a mean follow-up period of 13.2 +/- 1.5 months, the hernia recurrence rate was 27% (n = 21).


CONCLUSIONS
Although ADM is a viable option in AWR, the high hernia recurrence rate warrants a continued search for alternative biologic materials to improve outcomes.
Lee
Edward I
EI
Division of Plastic Surgery, Houston, TX, USA.
Chike-Obi
Chuma J
CJ
Gonzalez
Patricio
P
Garza
Ramon
R
Leong
Mimi
M
Subramanian
Anuradha
A
Bullocks
Jamal
J
Awad
Samir S
SS
D034861:Abdominal Wall / Q000601:surgery*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007412:Intestinal Fistula / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012008:Recurrence; D012307:Risk Factors; D017768:Skin, Artificial; D013530:Surgical Wound Infection / Q000601:surgery
C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen