title: Porcine Acellular Dermal Matrix for Hernia Repair in Transplant Patients.
abstract: OBJECTIVE
  The purpose of this study was to compare clinical outcomes of incisional hernia repair in solid organ transplant patients using non-cross-linked porcine acellular dermal matrix (PADM), human derived acellular dermal matrix (HADM) and synthetic mesh.
  
  
  METHODS
  A retrospective review of patients who underwent hernia repair with PADM after pancreas and/or renal transplant at the University of Maryland Medical Center from 2008 to 2012 was conducted. Repair type, postoperative infection, hernia recurrence, mesh removal, and length of follow-up were recorded. Results were compared with our previously published data evaluating HADM and synthetic mesh used in transplant patients between 2000 and 2005.
  
  
  RESULTS
  Twenty-seven patients underwent ventral hernia repair with PADM, 34 patients were repaired with HADM and 26 were repaired with synthetic mesh. The rate of wound infection in those repaired with PADM, HADM, and synthetic mesh were 14.8%, 14.7%, and 65.4%, respectively. Rates of recurrence were 13.3%, 23.5%, and 76.9%, respectively. Rate of mesh removal was found to be 7.4%, 11.8%, and 69.2%, respectively. These complication rates were significantly lower in patients who received HADM or PADM compared with patients repaired with synthetic mesh (P < 0.001). There was no statistically significant difference in the outcomes between the groups repaired with HADM or PADM.
  
  
  CONCLUSIONS
  The use of PADM for incisional hernia repair after kidney and/or pancreas transplant significantly reduces the incidence of hernia recurrence, wound infection, and need for mesh removal compared to synthetic mesh. No difference in morbidity between HADM and PADM was observed in the study population; however, longer follow-up in the PADM group is warranted.
authors.affiliation: From the *Division of Plastic & Reconstructive Surgery, University of Maryland School of Medicine; †Department of Plastic & Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD; ‡Vanderbilt University School of Medicine, Nashville, TN; and §Division of Plastic Surgery, & Reconstructive Surgery, Anne Arundel Medical Center, Annapolis, MD.
authors.forename: Arvind U
authors.initials: AU
authors.lastname: Gowda
authors.forename: Colton H L
authors.initials: CH
authors.lastname: McNichols
authors.forename: Ishan
authors.initials: I
authors.lastname: Asokan
authors.forename: Jamil A
authors.initials: JA
authors.lastname: Matthews
authors.forename: E Bryan
authors.initials: EB
authors.lastname: Buckingham
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sabino
authors.forename: John S
authors.initials: JS
authors.lastname: Maddox
authors.forename: Sheri
authors.initials: S
authors.lastname: Slezak
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Rasko
authors.forename: Devinder P
authors.initials: DP
authors.lastname: Singh
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D000069290:Incisional Hernia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome