title: The biological prosthesis is a viable option for abdominal wall reconstruction in pediatric high risk defects.
abstract: BACKGROUND
  Our aim was to explore the indications for and outcome of biological prostheses to repair high risk abdominal wall defects in children.
  
  
  METHODS
  A retrospective chart review was performed of all cases of abdominal wall reconstruction in a single institution between 2007 and 2015. Demographic and clinical variables, technique and complications were described and compared between prosthesis types.
  
  
  RESULTS
  A total of 23 patients underwent abdominal wall reconstruction using a biological prosthesis including 17 neonates. The main indication was gastroschisis (17 patients) followed by ruptured omphalocele and miscellaneous conditions. Alloderm™ was most commonly used followed by Surgisis™, Strattice™, Flex-HD™ and Permacol™. In 22 cases wounds were contaminated or infected. Open bowel/stomas were present in 9 cases. Skin was not closed in 11 cases. Post-operative complication rate was 30% and hernia recurrence rate was 17% after a mean follow-up time of 16 months.
  
  
  CONCLUSIONS
  The use of a biological prosthesis may offer advantages over a synthetic mesh in pediatric high risk abdominal wall defects. The surgeon should be ready to consider its use in selected cases.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: Zmora.osnat@gmail.com.
authors.forename: Osnat
authors.initials: O
authors.lastname: Zmora
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Castle
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Papillon
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Stein
mesh_terms: D034861:Abdominal Wall / Q000002:abnormalities / Q000601:surgery*; D000293:Adolescent; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D006555:Hernia, Ventral / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D013526:Surgical Mesh; D016896:Treatment Outcome; D055815:Young Adult
keywords: Abdominal wall; Biological prosthesis; Children; Pediatric; Reconstruction