Use of Acellular Dermal Matrix Combined with a Component Separation Technique for Repair of Contaminated Large Ventral Hernias: A Possible Ideal Solution for this Clinical Challenge

2015 ◽  
Vol 81 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Fei Yang ◽  
Li Ji-Ye ◽  
Li Rong ◽  
Tian Wen
Keyword(s):  
Acellular Dermal Matrix ◽  
Component Separation ◽  
Separation Technique ◽  
Oblique Muscle ◽  
Dermal Matrix ◽  
Surgical Infection ◽  
Wound Debridement ◽  
Component Separation Technique ◽  
Acellular Dermal ◽  
Ventral Hernias

Repair of large contaminated ventral hernias is always challenging because of massive loss of muscular and fascial tissues, high risk of surgical infection and recurrence, and contraindication to use of a permanent prosthesis. This study reviewed retrospectively data of 35 patients with contaminated large ventral hernias who received repair using acellular dermal matrix combined with a component separation technique from 2009 to 2011. Twenty-one males and 14 females were identified with a mean age of 45.5 ± 12.5 years and a mean body mass index of 22.5 ± 5.8 kg/m2. Simultaneously, nine patients underwent bowel fistula resection, 13 patients underwent ostomy takedown, five patients underwent recurrent colon cancer dissection, and eight patients underwent infectious permanent mesh removal and wound débridement. Mean defect size was 125.0 ± 23.5 cm2. The aponeurosis of the external oblique muscle was transected and separated from internal oblique muscle to reach abdominal closure. A cellular dermal matrix was placed in an onlay fashion and mean mesh size was 300.0 ± 65.0 cm2. Thirty-five patients had a mean follow-up period of 36.5 ± 12.5 months. Wound bleeding and partial dehiscence occurred at 36 hours post-operatively. Five patients reported abdominal wall pain during the first postoperative month. Five patients developed surgical site infection. Four patients were detected to develop seroma with volume more than 20 mL by B-ultrasound examination. No recurrence and chronic foreign body sensation were followed up. Use of acellular dermal matrix combined with a component separation technique is safe and efficient management for repair of contaminated large ventral hernia, in which permanent prosthesis placement is contraindicated.

Complex abdominal hernia reconstruction using component separation of parts with acellular dermal matrix

2011 ◽  
Vol 213 (3) ◽  
pp. S94-S95 ◽  
Author(s):  
Jignesh V. Unadkat ◽  
Chrisitie Dudash ◽  
Randall Draper ◽  
Tony Maalouf ◽  
Dinakar Golla
Keyword(s):  
Acellular Dermal Matrix ◽  
Component Separation ◽  
Abdominal Hernia ◽  
Dermal Matrix ◽  
Acellular Dermal

The impact of component separation technique versus no component separation technique on complications and quality of life in the repair of large ventral hernias

2019 ◽  
Vol 34 (2) ◽  
pp. 981-987 ◽  
Author(s):  
Sean R. Maloney ◽  
Kathryn A. Schlosser ◽  
Tanushree Prasad ◽  
Paul D. Colavita ◽  
Kent W. Kercher ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Component Separation ◽  
Separation Technique ◽  
Component Separation Technique ◽  
The Impact ◽  
Ventral Hernias

Xenogenic (porcine) Acellular Dermal Matrix Promotes Growth of Granulation Tissues in the Wound Healing of Fournier Gangrene

2015 ◽  
Vol 81 (1) ◽  
pp. 92-95 ◽  
Author(s):  
Zhaoxin Zhang ◽  
Lei Lv ◽  
Masut Mamat ◽  
Zhao Chen ◽  
Zhitao Zhou ◽  
...  
Keyword(s):  
Acellular Dermal Matrix ◽  
Control Group ◽  
Preparation Time ◽  
Dermal Matrix ◽  
Wound Debridement ◽  
Fournier Gangrene ◽  
Hospitalization Period ◽  
Porcine Acellular Dermal Matrix ◽  
Wound Bed Preparation ◽  
Acellular Dermal

This article investigates the application values of Xenogenic (porcine) acellular dermal matrix (XADM) in preparation of a Fournier gangrene wound bed. Thirty-six consecutive cases of patients with Fournier gangrene between 2002 and 2012 were enrolled in our department of our hospital. The patients were divided into two groups according to different methods of wound bed preparation after surgical débridement, including the experimental group (17 cases) and the control group (19 cases). The wounds in the experimental group were covered with XADM after surgical wound débridement, whereas the wounds were cleaned with hydrogen peroxide and sodium hypochlorite solution (one time/day) in the control group. The wound bed preparation time and hospital stay were then compared in the two groups. The wound preparation time was 13.64 ± 1.46 days and hospitalization period was 26.06 ± 0.83 days in the experimental XADM group. In the control group, the wound bed preparation time and hospitalization period were 22.37 ± 1.38 and 38.11 ± 5.60 days, respectively. The results showed statistical differences between these two groups. When used in wound débridement after Fournier gangrene, XADM protects interecological organizations, promotes the growth of granulation tissues, and maximally retains function and morphology of the perineum and penis.

A Comparison of Component Separation With Porcine Acellular Dermal Reinforcement to Bovine Acellular Dermal Matrix in the Repair of Significant Midline Ventral Hernia Defects

2021 ◽  
pp. 000313482110508
Author(s):  
Robert W. Lightfoot ◽  
Caleb Thrash ◽  
Stephanie Thompson ◽  
Bryan K. Richmond
Keyword(s):  
Ventral Hernia ◽  
Statistical Significance ◽  
Acellular Dermal Matrix ◽  
Patient Characteristics ◽  
Small Sample ◽  
Defect Size ◽  
Component Separation ◽  
Wound Complications ◽  
Dermal Matrix ◽  
Acellular Dermal

Background The optimal material for reinforcement of complex abdominal ventral hernia repair (VHR) remains controversial. Biologic prostheses such as porcine and bovine acellular dermal matrix (PADM/BADM) have shown favorable results, but few head-to-head comparisons between the two types exist. We sought to provide such a comparison. Methods We performed a retrospective cohort study comparing 40 consecutive patients who underwent open component separation (CS/VHR) with PADM reinforcement to 39 consecutive patients who underwent open CS/VHR with BADM reinforcement at our institution. Patient characteristics, outcomes, complications, reoperations, and hernia recurrences were obtained by chart review. Fisher’s exact and t-test analyses compared patient characteristics and outcomes between the 2 cohorts. Statistical significance was set as P < .05. Results Patient groups did not differ significantly in race (P=.36), age (P=.8), BMI (P=.34), sex (P=.09), steroid usage (p-1.00), COPD (P=.43), number of previous abdominal operations (P=.66), and duration of follow-up (P=.65). There were significantly more smokers in the PADM group (37.5% vs 12.8%, P=.01). Mean defect size was significantly greater in the PADM group (372.5 cm2 vs 292. cm2 in the BADM group, P=.001) as was the number of Ventral Hernia Working Group (VHWG) grade III/IV hernias (65.0% vs 38.4%, P=.02). Recurrence rates were lower in the BADM group, (12.5% vs 5.1%, P=.26), as was recurrence or complications requiring reoperation (17.5% vs 5.1%, P=.15). Postoperative wound events were also significantly lower in the BADM group (30.0% vs 2.6%, P=.001). Conclusions In our series, CS/BADM was associated with significantly fewer wound complications. Recurrences and complications requiring reoperation were also fewer, which trended toward but did not reach statistical significance, presumably due to the small sample size. These findings indicating superiority of BADM over PADM are potentially confounded by the higher percentage of smokers, the larger mean defect size, and the higher number of VHWG III/IV patients in the PADM group. Further prospective study of these findings is warranted.

scholarly journals The Effect of Acellular Dermal Matrix on the Success of Primary Palatoplasty With Intravelar Veloplasty

2021 ◽  
Author(s):  
Hossein Abdali ◽  
Mohammad Ali Hoghooghi ◽  
Shirin Fattahpour ◽  
Fatemeh Derakhshandeh ◽  
Farnoosh Mohtashampour ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Acellular Dermal Matrix ◽  
Fistula Formation ◽  
Control Group ◽  
Dermal Matrix ◽  
Surgical Infection ◽  
And Control ◽  
Acellular Dermal ◽  
Positive Results ◽  
Intravelar Veloplasty

Abstract BackgroundAcellular Dermal Matrix graft is usually used to repair fistulas following a cleft palate and has had positive results. But its use for primary palatoplasty has been less studied. Our aim was to compare the usefulness of using Acellular Dermal Matrix transplantation for primary palatoplasty with intravelar veloplasty in contrast to its lack of useMaterials and methodsA total of 72 children (6 months to 6 years old) with cleft palate were included in the study. The case-control prospective observations were conducted. A group underwent primary palatoplasty with intravelar veloplasty using Acellular Dermal Matrix and the control group had the same surgery without using Acellular Dermal Matrix. Patients were monitored for fistula formation, post-operative infection, and ulcers.ResultsNo post-surgical infection and wound opening was seen in any group. In the recipients of Acellular Dermal Matrix and control group three and six fistula was reported in which patients had soft and hard palate involvement and the cleft with length greater than 15 mm.ConclusionsConsidering the double incidence of fistulas in the control group compared to the ADM recipient, it seems that the use of ADM can be effective in reducing the incidence of fistulas. Since fistula is one of the complications of primary palatoplasty surgery and leads to secondary surgeries, the use of ADM can be helpful.

The principles of complex abdominal hernia repair

2021 ◽  
pp. 1185-1194
Author(s):  
Kezia Echlin ◽  
Andrew Fleming
Keyword(s):  
Significant Risk ◽  
Rectus Abdominis ◽  
Component Separation ◽  
Separation Technique ◽  
Abdominal Hernia ◽  
Wound Complications ◽  
Component Separation Technique ◽  
Epigastric Artery ◽  
Deep Inferior Epigastric Artery ◽  
Ventral Hernias

Large, complex abdominal hernias can be repaired with the component separation technique, which creates sliding bipedicled flaps of the rectus abdominis to allow autogenous repair of midline, ventral hernias. This technique involves longitudinal release of the external oblique aponeurosis just lateral to the linea semilunaris, and developing the plane between the external and internal oblique muscles to allow the rectus abdominis muscle and sheath to slide medially. Modifications of the original technique include the addition of mesh reinforcement, release of the deeper elements of the abdominal wall, and sparing of the peri-umbilical perforators to the skin from the deep inferior epigastric artery. Component separation technique is an effective technique to repair large ventral hernias but carries a significant risk of wound complications and a risk of cardiorespiratory compromise.

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