The use of porcine acellular dermal matrix in a bridge technique for complex abdominal wall reconstruction: An outcome analysis

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.