Human acellular dermal matrix for closure of a contaminated gynecologic wound
Celestine S Tung1, Israel Zighelboim, Bradford Scott
1Department of Obstetrics and Gynecology, Baylor College of Medicine, 1709 Dryden Road, Suite 1141, Houston, TX 77030, USA.
Background:
Polypropylene mesh for abdominal wall reconstruction increases the risk of postoperative complications in previously irradiated patients or patients with contaminated operative fields. A novel alternative, acellular dermal matrix, easily incorporates into native tissue when used for fascial reconstruction, forming a strong repair with minimal adhesions and lower infection rates.
Case:
We describe a patient previously treated with radiation for cervical cancer who presented with a contaminated operative field due to enteral spillage and pelvic infection. Acellular dermal matrix was used as part of a stepwise secondary closure of a large fascial defect in the anterior abdominal wall that was the result of repeated surgical procedures.
Conclusion:
Use of acellular dermal matrix rather than traditional polypropylene mesh should be considered for patients with contaminated or irradiated operative fields.
