Abdominal wall repair using human acellular dermal matrix: a follow-up study
Edward I Lee1, Chuma J Chike-Obi, Patricio Gonzalez
1Division of Plastic Surgery, Houston, TX, USA.
American Journal of Surgery
|November 6, 2009
Summary
Acellular dermal matrix (ADM) is a viable option for abdominal wall reconstruction (AWR), but its use is associated with a high hernia recurrence rate, necessitating further research into alternative materials.
Area of Science:
- Surgical Innovation
- Biomaterials Science
- Gastrointestinal Surgery
Background:
- The efficacy of acellular dermal matrix (ADM) in abdominal wall reconstruction (AWR) remains uncertain.
- A comprehensive review of AWR management using ADM was conducted to assess outcomes.
- This study evaluated a large surgical cohort for complications and long-term results.
Purpose of the Study:
- To review the management of abdominal wall reconstruction (AWR) utilizing acellular dermal matrix (ADM).
- To analyze complications associated with AWR when using ADM.
- To determine the long-term outcomes, including hernia recurrence rates, of AWR with ADM.
Main Methods:
- Retrospective chart review of patients undergoing AWR with ADM between 2004 and 2007.
- Collection of demographic data, comorbidities, perioperative, and long-term outcomes.
- Analysis of wound closure methods and time to nonprimary closure.
Main Results:
- The study included 77 cases in 68 patients (mean age 61.1 years).
- Infected fascia was the most common indication (25%). Wound closure was achieved in 75% of cases.
- A high rate of complications (39% perioperative, 43% long-term) and a 27% hernia recurrence rate were observed over a mean follow-up of 13.2 months.
Conclusions:
- Acellular dermal matrix (ADM) can be considered a feasible option for abdominal wall reconstruction (AWR).
- The significant hernia recurrence rate associated with ADM highlights the need for improved reconstructive techniques.
- Further investigation into alternative biologic materials is recommended to enhance AWR outcomes.
