title: Bovine versus porcine acellular dermal matrix for complex abdominal wall reconstruction.
abstract: BACKGROUND
  Abdominal wall reconstruction with bioprosthetic mesh is associated with lower rates of mesh infection, fistula formation, and mesh explantation than reconstruction with synthetic mesh. The authors directly compared commonly used bioprosthetic meshes in terms of clinical outcomes and complications.
  
  
  METHODS
  A database of consecutive patients who underwent abdominal wall reconstruction with porcine or bovine acellular dermal matrix and midline musculofascial closure at their institution between January of 2008 and March of 2011 was reviewed. Surgical outcomes were compared.
  
  
  RESULTS
  One hundred twenty patients were identified who underwent a nonbridged, inlay abdominal wall reconstruction with porcine [69 patients (57.5 percent)] or bovine acellular dermal matrix (51 patients (42.5 percent)]. The mean follow-up time was 21.0 ± 9.9 months. The overall complication rate was 36.6 percent; the porcine matrix group had a significantly higher complication rate (44.9 percent) than the bovine matrix group (25.5 percent; p = 0.04) and statistically equivalent surgical complications (29.2 percent versus 21.6 percent; p = 0.34). There were no significant differences in rates of recurrent hernia (2.9 percent versus 3.9 percent; p = 0.99) or bulge (7.2 percent versus 0 percent; p = 0.07). However, the rate of intraoperative adverse events in the porcine matrix group [seven events (10.1 percent)] was significantly higher than that in the bovine matrix group (0 percent; p = 0.02).
  
  
  CONCLUSIONS
  In patients who undergo complex abdominal wall reconstruction, both bovine and porcine acellular dermal matrix are associated with similar rates of postoperative surgical complications and appear to result in similar outcomes. Porcine acellular dermal matrix may be prone to intraoperative device failure.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Houston, Texas From the Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Clemens
authors.forename: Jesse C
authors.initials: JC
authors.lastname: Selber
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: David M
authors.initials: DM
authors.lastname: Adelman
authors.forename: Donald P
authors.initials: DP
authors.lastname: Baumann
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Garvey
authors.forename: Charles E
authors.initials: CE
authors.lastname: Butler
mesh_terms: D000008:Abdominal Neoplasms / Q000601:surgery*; D034861:Abdominal Wall / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques; D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002417:Cattle; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016012:Poisson Distribution; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies; D013552:Swine; D016896:Treatment Outcome