title: Early Clinical Outcomes of a Novel Antibiotic-Coated, Non-Crosslinked Porcine Acellular Dermal Graft after Complex Abdominal Wall Reconstruction.
abstract: Non-crosslinked porcine acellular dermal grafts (NCPADG) are currently the mainstay biomaterial for abdominal wall reconstruction (AWR) in complex hernia patients. We report early clinical outcomes using a novel rifampin/minocycline-coated NCPADG for AWR.
  
  
  
  A multi-institutional retrospective review was performed of patients who underwent ventral hernia repair using XenMatrix AB Surgical Graft (CR Bard, Inc [Davol]). Patient demographics, hernia and procedure characteristics, and surgical site occurrences/postoperative complications were reviewed up to 6 months after AWR.
  
  
  
  Seventy-four patients underwent AWR using XenMatrix AB Surgical Graft. Open AWR was performed in 52 patients (70.3%), and 22 patients (29.7%) underwent laparoscopic VHR. Median hernia size/area was 66.0 cm(2) (range 9.4 to 294.5 cm(2)). Sixteen patients (21.6%) had previous wound infections, and 16 patients (21.6%) had violation of the gastrointestinal tract during hernia repair. The most common locations of NCPADG placement were within the intraperitoneal (32.4%) and onlay (21.6%) positions, respectively. Median hospital length of stay was 4 days. Within 30 days after AWR, 6 (8.1%) patients were readmitted, postoperative seroma formation developed in 4 (5.4%) patients, 1 patient required percutaneous drainage, and surgical site infections developed in 5 (6.8%) patients. At 6 months follow-up, hernia recurrence had developed in 4 (5.4%) patients.
  
  
  
  Data suggest that use of a novel rifampin/minocycline-coated NCPADG was associated with a low rate of postoperative surgical site occurrences/postoperative complications during the first 30 days of follow-up in complex AWR patients. In addition, data suggest a low rate of hernia recurrence at 6-month follow-up. Additional study is warranted to determine whether early antimicrobial protection of the device translates into longer-term protection of the repair.
authors.affiliation: Department of Surgery, Carolinas Medical Center, Charlotte, NC.
authors.forename: Erin H
authors.initials: EH
authors.lastname: Baker
authors.affiliation: Division of Plastic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Darren
authors.initials: D
authors.lastname: Lepere
authors.affiliation: Division of Plastic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Megan P
authors.initials: MP
authors.lastname: Lundgren
authors.affiliation: Division of Plastic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Greaney
authors.affiliation: Division of Plastic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: David A
authors.initials: DA
authors.lastname: Ehrlich
authors.affiliation: Division of Plastic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Copit
authors.affiliation: Department of Surgery, Oklahoma University Medical Center, Oklahoma City, OK.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Murphree
authors.affiliation: Division of Advanced Laparoscopic and General Surgery, Presbyterian Hospital/St Luke's, Denver, CO.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Canfield
authors.affiliation: Division of Colon and Rectal Surgery, Jersey Shore Medical Center, Neptune, NJ.
authors.forename: Glenn
authors.initials: G
authors.lastname: Parker
authors.affiliation: Department of Surgery, Carolinas Medical Center, Charlotte, NC. Electronic address: David.Iannitti@carolinashealthcare.org.
authors.forename: David A
authors.initials: DA
authors.lastname: Iannitti
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D008911:Minocycline; D012293:Rifampin