title: Non-crosslinked porcine acellular dermal matrix in pediatric abdominal wall reconstruction: a case series.
abstract: BACKGROUND
  The use of biologic mesh where native tissue deficiencies limit reconstructive options has been well documented in the adult population, with increasing use to address the special requirements of complex abdominal wall reconstruction. There is, however, little documented evidence as to the safety and efficacy of these products in the pediatric population.
  
  
  METHODS
  This retrospective case series details 5 pediatric cases of complicated abdominal hernia repair with Strattice®, a non-crosslinked porcine acellular dermal matrix. Outcomes measured include recurrence, infection, seroma formation, symptomatic bulging, and need for mesh removal. Defect size, mesh size, and history of prior abdominal operations and infection were also recorded.
  
  
  RESULTS
  Patients received Strattice® with an average area of 132.2 (24-250)cm2and primary closure was achieved over a mesh underlay in three (60%) patients, while the remaining required a bridging approach secondary to lateral defects. Complications included suture extrusion, requiring suture removal, hernia recurrence without bulge, noted incidentally, and seroma formation, requiring placement of drains.
  
  
  CONCLUSIONS
  In conclusion, the use of porcine ADM in pediatric patients appears to be potentially safe and efficacious in the context of complex abdominal wall defects, including those with substantial contamination. Our small series builds on previous reports in this difficult patient population. Although additional study, with larger subject pools, would assist in solidifying the observations seen in this and other series, initial findings suggest that porcine ADM is a valuable tool in the treatment of these complex patients.
  
  
  METHODS
  Case series: Treatment study, Level IV.
authors.affiliation: Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Siy
authors.affiliation: Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. Electronic address: pferdehi@bcm.edu.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Pferdehirt
authors.affiliation: Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Shayan A
authors.initials: SA
authors.lastname: Izaddoost
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003094:Collagen; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
chemical_list: C568444:strattice; D003094:Collagen
keywords: Abdominal wall reconstruction; Acellular dermal matrix; Biologic mesh; Component separation; Strattice; Ventral hernia