当前位置： SCI文献检索 > AMERICAN JOURNAL OF SURGERY期刊下所有文献 > The use of acellular dermal matrix for contaminated abdominal wall defects: wound status predicts success.

The use of acellular dermal matrix for contaminated abdominal wall defects: wound status predicts success.

Abstract：

BACKGROUND:Contaminated abdominal wall fascial defects present a challenging problem. The use of human acellular dermal matrix (AlloDerm; LifeCell Corp., Branchburg, NJ) provides a novel method of primary closure of abdominal wall defects in this setting. The aim of the current study was to determine what factors predicted fascial wall failure as determined by the presence of hernia on follow-up exam after AlloDerm placement. METHODS:All patients who underwent surgery for contaminated abdominal wall fascial defects with placement of AlloDerm from June 2003 to September 2005 at a tertiary care Veterans Affairs hospital were included in the analysis. Patients were followed until hernia recurrence or last clinic visit. RESULTS:Eighteen patients had AlloDerm placed for contaminated fascial defects and all were included in the analysis. Primary wound closure was performed on 12/18 (67%) patients, with 6/18 (33%) patients initially left with open wounds. Patients with open wounds were treated with wound vacuum-assisted closure (VAC) devices (4/6) or saline dressings (2/6). Overall ventral hernia recurrence rate was 50% (9/18) with an average follow up of 9.1 months. Patients who had primary wound closure at the completion of the operation had a 33% (4/12) recurrence rate. Patients who did not have primary wound closure had an 83.3% (5/6) recurrence rate. The significant difference shows (P = .03) that open wound status predicts recurrence. The average size of AlloDerm sheets used was 164.0 cm2 in the closed group and 146.2 cm2 in the primary open wound group (P = .64). Average cost per patient was 4680 dollars for AlloDerm. CONCLUSION:These data suggest that an open wound in the postoperative period after AlloDerm placement for treatment of contaminated fascial defects is associated with a high probability of hernia recurrence. Our data do not support the use of this expensive material unless there is a good chance of having a closed wound.

journal_name

Am J Surg

journal_title

American journal of surgery

authors

Schuster R,Singh J,Safadi BY,Wren SM

doi

10.1016/j.amjsurg.2006.08.017

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

594-7

issue

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(06)00515-0

journal_volume

192

pub_type

杂志文章

在线工具

The use of acellular dermal matrix for contaminated abdominal wall defects: wound status predicts success.