title: Abdominal wall defect repair with biological prosthesis in transplanted patients: single center retrospective analysis and review of the literature.
abstract: The risk of fascial dehiscence, wound infection and incisional hernias in organ recipients is higher. Retrospective analysis of our departments database, checking the last 12 years (2000-2012), and of the literature (1966-2012) were conducted. In our database we found seven patients: five liver (71.4 %), one kidney (14.3 %), one multivisceral (14.3 %); five males (71.4 %), two females (28.6 %). Five (71.4 %) were operated in urgency setting and two in ordinary setting (28.6 %). The mean/median number of laparotomies before the incisional hernia is of 2.1/1 (range 1-5). In five patients swine intestinal submucosa (71.4 %) have been used and in two porcine dermal collagen (28.6 %). The mean/median age was 48.3/52 years (range 18-61). The mean/median body mass index was 26.7/27 (range 19-34). The mean/median for follow-up after intervention was 40.1/33 months (range 50-21). Recurrence rate was 14.3 %. Complication rate was 28.6 %. Adding the present report, the literature reports 70 cases. 20 % of prosthesis have been implanted inlay, 25.7 % underlay, in 5.7 % intraperitoneal and in 48.6 % were not specified. The mean age ranges from 0.7 to 48.3 years. Kidney, liver, pancreas, bowel and multivisceral transplant are reported. Porcine dermal collagen has been implanted in 24.3 %, human dermal collagen in 51.4 % and swine intestinal submucosa in 24.3 %. The immunosuppression regimens comprehend variable associations of tacrolimus, steroids, mycophenolate mofetil, sirolimus, thymoglobulin, azathioprine/basiliximab and daclizumab. The mean follow-up is 16.2 months. The mean complication rate is 9.4 %. Biological prosthesis seems to be useful and safe in abdominal wall repair surgery in transplanted patients.
authors: Unit of General Surgery, Papa Giovanni XXIII hospital, P.zza OMS 1, 24127, Bergamo, Italy, federico.coccolini@gmail.com.
authors: Federico
authors: F
authors: Coccolini
authors: Fausto
authors: F
authors: Catena
authors: Valentina R
authors: VR
authors: Bertuzzo
authors: Giorgio
authors: G
authors: Ercolani
authors: Antonio
authors: A
authors: Pinna
authors: Luca
authors: L
authors: Ansaloni
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000209:etiology / Q000601:surgery*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D012196:Review Literature as Topic; D013529:Surgical Wound Dehiscence / Q000150:complications / Q000601:surgery*; D014945:Wound Healing; D055815:Young Adult
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