title: The use of porcine acellular dermal matrix in a bridge technique for complex abdominal wall reconstruction: an outcome analysis.
abstract: BACKGROUND
  Outcomes using the porcine acellular dermal matrix (PADM) in abdominal wall reconstruction (AWR) have been reported when used for midline reinforcement; however, there have been no reports focused on outcomes when used as a bridging mesh.
  
  
  METHODS
  A retrospective review was conducted of all patients who underwent AWR with a non-cross-linked PADM as a bridged repair without midline fascial approximation.
  
  
  RESULTS
  Nine patients were identified with an average follow-up of 546 days. The average preoperative hernia defect diameter was 22.4 cm. After PADM placement, the average defect diameter was 9.8 cm. Complications occurred in 55.6% of patients, with PADM exposure occurring in all of these patients. No PADM was explanted, and all patients eventually healed. Abdominal wall eventration and/or recurrence occurred in 8 of 9 (88.9%) patients.
  
  
  CONCLUSIONS
  When fascial approximation cannot be achieved, PADM bridging may be the best option to avoid complications associated with synthetic mesh. However, there is a high potential for abdominal wall eventration and/or recurrence.
authors.affiliation: Department of Plastic Surgery, Georgetown University Hospital, Washington, DC 20007, USA.
authors.forename: Ketan M
authors.initials: KM
authors.lastname: Patel
authors.forename: Maurice Y
authors.initials: MY
authors.lastname: Nahabedian
authors.forename: Frank
authors.initials: F
authors.lastname: Albino
authors.forename: Parag
authors.initials: P
authors.lastname: Bhanot
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D061645:Abdominoplasty / Q000379:methods*; D062088:Acellular Dermis / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome