Lee EI, Chike-Obi CJ, Gonzalez P, Garza R, Leong M, Subramanian A, Bullocks J, Awad SS
Abdominal wall repair using human acellular dermal matrix: a follow-up study. [Journal Article]
Am J Surg 2009 Nov; 198(5):650-7.
BACKGROUND: The role of acellular dermal matrix (ADM) in abdominal wall reconstruction (AWR) is unclear. The aim of this study was to review the management, complications, and long-term outcomes of AWR using ADM in a large surgical cohort.
METHODS: Retrospective chart review of patients undergoing AWR using ADM from 2004 to 2007 was performed. Demographic data, comorbidities, complications, and long-term outcomes were collected.
RESULTS: There were 77 cases in 68 patients with mean age of 61.1 +/- 1.4 years. The most common indication was infected fascia (n = 19 [25%]). Wound closure was achieved in 75% of the cases via primary (n = 26 [45%]), secondary intention (n = 17 [29%]), or skin graft (n = 15 [26%]). Nonprimary closure was achieved in 5.7 +/- .7 months. There were 32 perioperative (39%) and 33 long-term (43%) complications. Over a mean follow-up period of 13.2 +/- 1.5 months, the hernia recurrence rate was 27% (n = 21).
CONCLUSION: Although ADM is a viable option in AWR, the high hernia recurrence rate warrants a continued search for alternative biologic materials to improve outcomes.
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