title: Review of AlloDerm Acellular Human Dermis Regenerative Tissue Matrix in Multiple Types of Oculofacial Plastic and Reconstructive Surgery.
abstract: OBJECTIVE
  AlloDerm acellular human dermis is used for repair or replacement of damaged or inadequate skin tissue. It has been used successfully in multiple types of surgeries, including abdominal wall reconstruction, breast reconstruction, and head and neck reconstruction. Its application to ophthalmic plastic and reconstructive surgery is less well described. This study seeks to evaluate the efficacy and factors influencing surgical outcomes using Alloderm in multiple types of oculofacial plastic surgery.
  
  
  METHODS
  Institutional Review Board-approved retrospective review of 84 patients who underwent surgical procedures using Alloderm. Preoperative demographic data, comorbidities, smoking, clinical etiology, surgical methods, Alloderm type, and outcome (cosmetic and functional) were evaluated.
  
  
  RESULTS
  This study included 84 patients, accounting for a total of 98 procedures. Mean age was 52.5 years (3-93 years). Etiologies necessitating surgery included malignancy in 26 patients (31.0%), trauma in 19 patients (22.6%), congenital lesions in 15 patients (17.9%), and senile change in 11 patients (13.1%). Surgical procedures included lower eyelid posterior lamella elongation, socket and fornix reconstruction, scar repair, patch grafts, and filler. Mean duration of follow up was 530 days. Overall, 92.8% of patients had favorable outcomes. Factors associated with significantly worse outcomes included smoking, congenital anomaly etiologies, and previous graft/flaps in the same area (p = 0.03, p = 0.029, and p = 0.007, respectively).
  
  
  CONCLUSIONS
  This study suggests that Alloderm acellular human dermis can be used safely and effectively in multiple types of oculofacial procedures. Smoking, congenital anomaly etiologies, and previous graft/flap were associated with poor cosmetic and functional outcomes.
authors.affiliation: *Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung; †National Defense Medical Center, Taipei; ‡Yuh-Ing Junior College of Health Care and Management, Kaohsiung, Taiwan; §Scripps Mercy Hospital, San Diego, California; and ‖Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, U.S.A.
authors.forename: Youn-Shen
authors.initials: YS
authors.lastname: Bee
authors.forename: Brock
authors.initials: B
authors.lastname: Alonzo
authors.forename: John D
authors.initials: JD
authors.lastname: Ng
mesh_terms: D062088:Acellular Dermis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012189:Retrospective Studies; D017768:Skin, Artificial; D013518:Surgery, Plastic
chemical_list: C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen