Use of human acellular dermal matrix for abdominal wall reconstructions

Maurice, Samuel M.; Skeete, Dionne A.

doi:10.1016/j.amjsurg.2007.11.019

« Previous Next »The American Journal of Surgery
Volume 197, Issue 1 , Pages 35-42, January 2009

Use of human acellular dermal matrix for abdominal wall reconstructions

Department of Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, USA

Received 30 August 2007; received in revised form 26 November 2007 published online 16 June 2008.

Abstract

Background

Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects.

Methods

We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications.

Results

Postoperative wound infections, noninfectious wound complications, and recurrences developed in 35%, 44%, and 41% of patients, respectively. No patients required ADM removal. Long surgical times (≥300 min), implants of 100 cm² or greater, and repairs using 3 or more ADM sheets were associated significantly with the development of a postoperative wound infection. The approximation of ADM directly to the fascial edge (P = .02), long surgical time (P < .01), implant size of 100 cm² or greater (P = .01), and the presence of a postoperative wound infection (P = .02) were associated significantly with recurrence.

Conclusions

Recurrences and complications after ADM fascial repairs may be higher than previously reported and associated with implant size and method of implantation. Postoperative infection, although not necessitating implant removal, is associated with more recurrences.

Keywords: Biologic prosthesis, Acellular dermal matrix, AlloDerm, Hernia, Hernia repair