Delayed primary closure of contaminated abdominal wall defects with non-crosslinked porcine acellular dermal matrix compared with conventional staged repair: a retrospective study

Journal of Medical Case Reports

Stefan Schopf¹  Martin von Ahnen¹  Thomas von Ahnen¹  Francesca Di Cerbo¹  Hans M Schardey¹ 

[1] Department of General, Visceral and Vascular Surgery, Agatharied Academic Teaching Hospital of the Ludwig Maximilians University, Norbert Kerkel Platz, D 83734 Agatharied, Germany

关键词: Porcine-derived acellular dermal matrix;    Cost;    Strattice;    Contaminated hernia repair;   

Others  :  1181101
DOI  :  10.1186/1752-1947-8-251

 received in 2013-11-18, accepted in 2014-04-28,  发布年份 2014

【 摘 要 】

Introduction

Synthetic mesh has been used traditionally to repair abdominal wall defects, but its use is limited in the case of bacterial contamination. New biological materials are now being used successfully for delayed primary closure of contaminated abdominal wall defects. The costs of biological materials may prevent surgeons from using them. We compared the conventional staged repair of contaminated abdominal wall defects with a single-stage procedure using a non-crosslinked porcine acellular dermal matrix.

Methods

A total of 14 cases with Grade 3 contaminated abdominal wall defects underwent delayed primary closure of the abdomen using a non-crosslinked porcine acellular dermal matrix (Strattice™ Reconstructive Tissue Matrix, LifeCell Corp., Branchburg, NJ, USA). The results were compared with a group of 14 patients who had received conventional treatment for the repair of contaminated abdominal wall defects comprising a staged repair during two separate hospital admissions employing synthetic mesh. Treatment modalities, outcomes, and costs were compared.

Results

In all cases treated with delayed primary closure employing non-crosslinked porcine acellular dermal matrix, there were no complications related to its use. Two patients died due to unrelated events. Although treatment costs were estimated to be similar in the two groups, the patients treated with porcine acellular dermal matrix spent less time as an inpatient than those receiving conventional two-stage repair.

Conclusions

Delayed primary closure of contaminated abdominal wall defects using a non-crosslinked porcine acellular dermal matrix may be a suitable alternative to conventional staged repair. In our patients, it resulted in early restoration of abdominal wall function and shorter hospitalization. The costs for treating contaminated abdominal wall defects using porcine acellular dermal matrix during a single hospital admission were not higher than costs for conventional two-stage repair. Further randomized studies are needed to expand upon these findings.

【 授权许可】

   
2014 Schardey et al.; licensee BioMed Central Ltd.

【 图 表 】

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