scholarly journals Reconstruction of Diaphragmatic Defects With Human Acellular Dermal Matrix

2018 ◽  
Vol 4 ◽  
pp. 2513826X1775111 ◽  
Author(s):  
Valerie Hurdle ◽  
Kristine Ly ◽  
Justin K. Yeung ◽  
Andrew J. Graham ◽  
Gary A. Gelfand ◽  
...  
Keyword(s):  
Literature Review ◽  
Acellular Dermal Matrix ◽  
Published Data ◽  
Dermal Matrix ◽  
Number Of Patients ◽  
Operative Complications ◽  
Acellular Dermal ◽  
Human Acellular Dermal Matrix ◽  
Post Operative Complications

Large diaphragmatic defects present a reconstructive challenge, often necessitating the use of synthetic materials. We report our experience reconstructing large diaphragmatic defects using human acellular dermal matrix (HADM). Patients unable to undergo primary repair of diaphragmatic defects from 2009 to 2013 were reconstructed using HADM. A chart review was performed to investigate immediate and late post-operative outcomes. Construct stability was assessed with repeat imaging. In addition, a literature review was performed to identify studies in which HADM had been used for diaphragm repair. Four patients required reconstruction of large hemi-diaphragmatic defects. All patients had chest tubes placed, which remained in situ from 4 to 10 days post-operatively. Two patients also had drains in dead space surrounding HADM; these were removed between 6 and 9 days post-procedure. Length of hospital stay ranged from 8 to 65 days. Post-operative complications were seen in 2 patients: surgical site cellulitis and failure of extubation due to persistent respiratory failure. There were no adverse events related to HADM, and all patients remained disease free without evidence of repair failure on radiographic follow-up, ranging from 14 to 62 months. The literature review identified 3 studies in which all diaphragms repaired with HADM remained intact without need for explantation despite common post-operative complications including fluid collections and surgical site infections. Diaphragm reconstruction with HADM is limited to a small number of patients and modest follow-up periods; the neodiaphragms appear durable in contaminated fields, without evidence of repair failure. Our results, and previously published data, indicate HADM is a reasonable option for diaphragm repair.

Abdominal wall repair using human acellular dermal matrix: a follow-up study

2009 ◽  
Vol 198 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Edward I. Lee ◽  
Chuma J. Chike-Obi ◽  
Patricio Gonzalez ◽  
Ramon Garza ◽  
Mimi Leong ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Acellular Dermal Matrix ◽  
Dermal Matrix ◽  
Abdominal Wall Repair ◽  
Follow Up Study ◽  
Acellular Dermal ◽  
Human Acellular Dermal Matrix

scholarly journals Acellular dermal matrix as filler in breast-conserving surgery: warnings for a careful use

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Gianluca Franceschini ◽  
Riccardo Masetti
Keyword(s):  
Acellular Dermal Matrix ◽  
Breast Conserving Surgery ◽  
Human Origin ◽  
Dermal Matrix ◽  
Adequate Knowledge ◽  
Aesthetic Results ◽  
Dermal Matrices ◽  
Acellular Dermal ◽  
Human Acellular Dermal Matrix ◽  
Host Tissues

AbstractAcellular dermal matrices are biological materials of porcine, bovine, or human origin used as scaffold for reconstructive purpose in plastic surgery; these materials are well-tolerated and safely integrated in host tissues without causing resorption, contracture, and encapsulation thanks to their low antigenicity.Recently, human acellular dermal matrix has been used as a filler in breast-conserving surgery to improve aesthetic results. Adequate knowledge of biomaterials properties, appropriate skill, and careful compliance with some specific recommendations are mandatory in order to optimize outcomes and obtain a work of success.

Citation Analysis in Breast Reconstruction Publications Between 2000 and 2010

2021 ◽  
pp. 229255032110499
Author(s):  
Rebecca Miller ◽  
Sheina Macadam ◽  
Daniel Demsey
Keyword(s):  
Breast Reconstruction ◽  
Citation Analysis ◽  
Case Series ◽  
Acellular Dermal Matrix ◽  
Fat Grafting ◽  
Fat Graft ◽  
Level Of Evidence ◽  
Dermal Matrix ◽  
Number Of Patients ◽  
Acellular Dermal

Introduction and Purpose: Breast reconstruction is an active area of plastic surgery research. Citation analysis allows for quantitative analysis of publications, with more citations presumed to indicate greater influence. We performed citation analysis to evaluate the most cited papers on breast reconstruction between 2000 to 2010 to identify contemporary research trends. Methods: The SCI-EXPANDED database was used to identify the 50 most cited papers. Data points included authorship, publication year, publication journal, study design, level of evidence, number of surgeons/institutions, center of surgery, primary outcome assessed, implant/flap/acellular dermal matrix/fat graft, acellular dermal matrix brand and use with implants/flaps, fat graft use with implants/flaps, unilateral/bilateral, one-/two-stage, immediate/delayed, number of patients/procedures, complications. Descriptive analysis of trends was performed based on results. Results: 20% of papers were published in 2006, 16% in 2007 and 12% in both 2004/2009. 66% were published in Plastic and Reconstructive Surgery. The majority were retrospective or case series, and of Level III or IV evidence. The one Level I study was a prospective multicenter trial. 21 and 7 papers discussed procedures by single/multiple surgeons, respectively. Results from single/multiple centers were discussed in 18 and 6 papers, respectively. 30 papers discussed implant-based reconstruction, 22 papers flap-based (19 microsurgical), 15 papers acellular dermal matrix, and five papers fat grafting. The primary focus in the majority was complications or outcomes. Conclusion: Our analysis demonstrates continually evolving techniques in breast reconstruction. However, there is notable lack of high quality evidence to guide surgical decision-making in the face of increasing surgical options.

Application of paste-type acellular dermal matrix in hard-to-heal wounds

2021 ◽  
Vol 30 (5) ◽  
pp. 414-418
Author(s):  
Sang Wha Kim ◽  
Hyung Sup Shim ◽  
Jihye Lee ◽  
Youn Hwan Kim
Keyword(s):  
Wound Healing ◽  
Adverse Events ◽  
Acellular Dermal Matrix ◽  
Complete Healing ◽  
Dermal Matrix ◽  
Wound Area ◽  
Number Of Patients ◽  
Complete Wound Healing ◽  
Zero Baseline ◽  
Acellular Dermal

Objective: The extracellular matrix (ECM) is one of the most important elements in wound healing. Absence or dysfunction of the ECM may impair wound healing. The application of acellular dermal matrix (ADM) as a substitute for ECM has been suggested. This study investigated the clinical application and wound healing effects of a paste-type ADM in patients presenting with hard-to-heal wounds due to various causes. Method: Patients with a hard-to-heal wound for >1 month, from September 2017 to February 2019, were included in this study. After debridement, the paste-type ADM was applied, at zero (baseline), two and four weeks. After application of the paste-type ADM, a conventional dressing was applied using polyurethane foam. Wound size, the formation of granulation tissue, re-epithelialisation, complete healing and adverse events were recorded at zero (baseline), one, two, four, eight and 12 weeks after the initial treatment. Results: A total of 18 patients took part (eight male, 10 female, mean age of 56±16.16 years). The mean wound area decreased from 17.42±10.04cm2 to 12.73±7.60cm2 by week one (p<0.05), to 10.16±7.00 by week two (p<0.0005), to 5.56±5.25 by week four (p<0.0001), to 2.77±5.15 by week eight (p<0.0001) and to 2.07±4.78 by week 12 (p<0.0001). The number of patients with >75% re-epithelialisation increased from two (11.1%) at two weeks to five (27.8%) at four weeks, to 11 (61.1%) at eight weeks and to 13 (72.2%) at 12 weeks. The number of patients showing complete wound healing was two (11.1%) at four weeks, nine (50.0%) at eight weeks and 12 (66.7%) at 12 weeks. No adverse events were reported during treatment. Conclusion: The paste-type ADM used in this study is a viable option for facilitating wound healing; it can shorten hospitalisation, and promote a faster recovery and return to normal life activities.

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