Management of complex abdominal wall defects using acellular porcine dermal collagen
Luis Felipe Chavarriaga1, Edward Lin, Albert Losken
1Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
The American Surgeon
|February 9, 2010
Summary
Acellular porcine dermal collagen shows potential for abdominal wall reconstruction but has high recurrence and complication rates. Encapsulation and infection led to graft removal in some cases, impacting long-term success.
Area of Science:
- Surgical Innovation
- Biomaterials Science
- Gastrointestinal Surgery
Background:
- Complex abdominal wall defects often result from recurrent incisional hernias, posing significant surgical challenges.
- Traditional primary repair methods have high recurrence rates, while prosthetic mesh is unsuitable for contaminated fields.
- Biologic prostheses offer an alternative approach for these difficult reconstructions.
Purpose of the Study:
- To evaluate the efficacy and outcomes of using acellular porcine dermal collagen for complex abdominal wall defect reconstruction.
- To assess complication rates, recurrence rates, and long-term results associated with this biomaterial.
Main Methods:
- Retrospective review of 18 patients undergoing abdominal wall reconstruction with acellular porcine dermal collagen (CollaMend) between August 2006 and May 2007.
- Analysis of patient demographics, risk factors, previous surgeries, and postoperative outcomes including complications and recurrences.
- Mean follow-up period of 7.3 months.
Main Results:
- A high recurrence rate of 44.4% was observed.
- Postoperative wound complications occurred in 38.9% of patients, with infection in 22.2%.
- Infection cases necessitated prosthesis removal due to encapsulation, not incorporation, of the biologic material.
Conclusions:
- Acellular porcine dermal collagen can be used for abdominal wall reconstruction, with complication rates comparable to other biologic materials.
- Graft encapsulation and infection pose significant challenges, often requiring prosthesis removal.
- Hernia recurrence and graft dehiscence remain concerns, particularly in non-compromised surgical fields.
