Jean-Francois Ouellet1, Chad G Ball2, John B Kortbeek3, Lloyd A Mack1, Andrew W Kirkpatrick4. 1. Department of Surgery, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada. 2. Department of Surgery, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada; Regional Trauma Services, Foothills Medical Centre, Calgary, Alberta, Canada. 3. Department of Surgery, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada; Regional Trauma Services, Foothills Medical Centre, Calgary, Alberta, Canada; Critical Care Medicine, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada. 4. Department of Surgery, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada; Regional Trauma Services, Foothills Medical Centre, Calgary, Alberta, Canada; Critical Care Medicine, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada. Electronic address: andrew.kirkpatrick@albertahealthservices.ca.
Abstract
BACKGROUND: Limited controlled data exist regarding the role of bioprosthetic meshes for hernia repair. Often the only option available in contaminated cases, their high cost calls for an evaluation of their utility and indications for use. METHODS: A retrospective review of cases in which human acellular dermal matrix (HADM) was used to reconstruct a thoracoabdominal wall defect at the Foothills Medical Centre of Calgary was conducted. Attention was placed to identify the need for surgical reintervention postoperatively. RESULTS: Over 2 years, 13 patients required the use of HADM for reconstruction of their thoracoabdominal wall; 69.2% of the cases were contaminated or infected. Three patients (23.1%) presented postoperative infectious complications; only 1 required reoperation. No patients required removal of their prosthesis. Two patients presented recurrences (median follow-up = 126 days). CONCLUSIONS: The use of HADM for complex thoracoabdominal wall defects in contaminated or infected settings is a reliable option available for surgeons.
BACKGROUND: Limited controlled data exist regarding the role of bioprosthetic meshes for hernia repair. Often the only option available in contaminated cases, their high cost calls for an evaluation of their utility and indications for use. METHODS: A retrospective review of cases in which human acellular dermal matrix (HADM) was used to reconstruct a thoracoabdominal wall defect at the Foothills Medical Centre of Calgary was conducted. Attention was placed to identify the need for surgical reintervention postoperatively. RESULTS: Over 2 years, 13 patients required the use of HADM for reconstruction of their thoracoabdominal wall; 69.2% of the cases were contaminated or infected. Three patients (23.1%) presented postoperative infectious complications; only 1 required reoperation. No patients required removal of their prosthesis. Two patients presented recurrences (median follow-up = 126 days). CONCLUSIONS: The use of HADM for complex thoracoabdominal wall defects in contaminated or infected settings is a reliable option available for surgeons.
Authors: Lawrence Lee; Juan Mata; Tara Landry; Kosar A Khwaja; Melina C Vassiliou; Gerald M Fried; Liane S Feldman Journal: Surg Endosc Date: 2014-03-12 Impact factor: 4.584