Authors: Faisal M Shaikh Subhasis K Giri Shaukat Durrani David Waldron Pierce A Grace
Publish Date: 2007/07/29
Volume: 31, Issue: 10, Pages: 1966-1972
Abstract
Elective or emergency reconstruction of abdominal wall defects AWD is often difficult Various techniques have been proposed for reconstructing AWD including the use of synthetic implants Porcine acellular dermal collagen PermacolTM is a biologic implant PADCI derived from porcine dermis We report our experience with the use of PADCI in the management of large AWD in both emergency and elective surgeryTwenty consecutive patients with chronic AWD CAWD arising from large incisional hernia or acute AWD AAWD arising from visceral edema or tumor resection were studied prospectively After musculofascial mobilization the AWD was closed using sheets 10 × 15 cm of PADCI as an “underlay” interposition graft Patients were followed up to a median of 18 months postoperativelyAll 20 defects were closed without tension using PADCI Eight and 12 patients had reconstruction for large AAWD and CAWD respectively The mean size of the defects was 180 cm2 range = 96–850 cm2 The median number of PADCI used to repair the defects was one sheet range = 1–7 Twelve patients 60 had an uneventful recovery and were discharged within seven days One patient 5 died from multipleorgan failure Seven patients 35 developed a complication two seromas two minor wound infections one wound hematoma one skin edge necrosis one superficial wound dehiscence and wound sinus Overall there were three recurrences 15
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