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Utilization of Human Cadaveric Acellular Dermis for Abdominal Hernia Reconstruction

Espinosa-de-los-Monteros, Antonio MD; de la Torre, Jorge I. MD, FACS; Marrero, Ian MD; Andrades, Patricio MD; Davis, Michael R. MD; Vásconez, Luis O. MD, FACS

doi: 10.1097/01.sap.0000254410.91132.a8
Original Article
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Background: Incisional hernias with history of recurrence or infection remain a challenge, with high postoperative morbidity and recurrence rates. The purpose of this study is to evaluate outcomes of patients treated with human cadaveric acellular dermis as an adjunct to abdominal wall reconstruction.

Methods: We retrospectively reviewed 39 abdominal wall reconstructions with human cadaveric acellular dermis performed in 37 patients and compared them with 39 randomly selected cases.

Results: There is a significant decrease in recurrence rates when human cadaveric acellular dermis is added as an overlay to primary closure plus rectus muscle advancement and imbrication in patients with medium-sized hernias. No differences were observed when adding human cadaveric acellular dermis as an overlay to patients with large-size hernias treated with underlay mesh. The use of human cadaveric acellular dermis did not increase postoperative morbidity rates.

Conclusions: Improved results with human cadaveric acellular dermis are obtained by achieving tension-free repairs.

Thirty-nine abdominal hernias were repaired by rectus advancement reinforced with human cadaveric acellular dermis overlay. Recurrences were significantly lower than a randomly selected control group repaired without the dermis overlay.

From the Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL.

Received October 2, 2006 and accepted for publication November 18, 2006.

Presented at the Annual Meeting of the Southeastern Society of Plastic and Reconstructive Surgeons, The Cloisters, Sea Island, GA, June 3–7, 2006.

Reprints: Jorge I. de la Torre, MD, 510 20th Street, South (FOT 1102), Birmingham, AL 35294. E-mail: jdlt@uab.edu.

© 2007 Lippincott Williams & Wilkins, Inc.