TY - JOUR
T1 - The use of porcine acellular dermal matrix in a bridge technique for complex abdominal wall reconstruction
T2 - An outcome analysis
AU - Patel, Ketan M.
AU - Nahabedian, Maurice Y.
AU - Albino, Frank
AU - Bhanot, Parag
PY - 2013/2
Y1 - 2013/2
N2 - Background: Outcomes using the porcine acellular dermal matrix (PADM) in abdominal wall reconstruction (AWR) have been reported when used for midline reinforcement; however, there have been no reports focused on outcomes when used as a bridging mesh. Methods: A retrospective review was conducted of all patients who underwent AWR with a non-cross-linked PADM as a bridged repair without midline fascial approximation. Results: Nine patients were identified with an average follow-up of 546 days. The average preoperative hernia defect diameter was 22.4 cm. After PADM placement, the average defect diameter was 9.8 cm. Complications occurred in 55.6% of patients, with PADM exposure occurring in all of these patients. No PADM was explanted, and all patients eventually healed. Abdominal wall eventration and/or recurrence occurred in 8 of 9 (88.9%) patients. Conclusions: When fascial approximation cannot be achieved, PADM bridging may be the best option to avoid complications associated with synthetic mesh. However, there is a high potential for abdominal wall eventration and/or recurrence.
AB - Background: Outcomes using the porcine acellular dermal matrix (PADM) in abdominal wall reconstruction (AWR) have been reported when used for midline reinforcement; however, there have been no reports focused on outcomes when used as a bridging mesh. Methods: A retrospective review was conducted of all patients who underwent AWR with a non-cross-linked PADM as a bridged repair without midline fascial approximation. Results: Nine patients were identified with an average follow-up of 546 days. The average preoperative hernia defect diameter was 22.4 cm. After PADM placement, the average defect diameter was 9.8 cm. Complications occurred in 55.6% of patients, with PADM exposure occurring in all of these patients. No PADM was explanted, and all patients eventually healed. Abdominal wall eventration and/or recurrence occurred in 8 of 9 (88.9%) patients. Conclusions: When fascial approximation cannot be achieved, PADM bridging may be the best option to avoid complications associated with synthetic mesh. However, there is a high potential for abdominal wall eventration and/or recurrence.
KW - Abdominal wall reconstruction
KW - Bridging
KW - Hernia complications
KW - Hernia recurrence
KW - Porcine acellular dermal matrix
UR - http://www.scopus.com/inward/record.url?scp=84872607701&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872607701&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2012.05.031
DO - 10.1016/j.amjsurg.2012.05.031
M3 - Article
C2 - 23195145
AN - SCOPUS:84872607701
SN - 0002-9610
VL - 205
SP - 209
EP - 212
JO - American journal of surgery
JF - American journal of surgery
IS - 2
ER -