Repair of complex abdominal incisional hernia with acellular dermal matrix

Abstract

Objective To evaluate the repair of abdominal complicated incisional hernia using acellular dermal matrix (ADM).Methods Retrospective analysis was made on 7 cases with abdominal complicated incisional hernia treated by ADM in our hospital from January 2008 to June 2010,among them there were 4 males and 3 females.Age ranged from 43 to 83 years and the median age was 53 years.Two concurrent indirect inguinal hernia cases were repaired and concurrent gastrointestinal tract problems including 2 small bowd fistulas were operated one stage in 5 cases.Mean diameter of hernia ring was ( 11.6 ± 2.8 ) cm,ranged from 9.2 to 16.5 cm.5 cases were repaired by using intraperitoneal onlay mesh,others using total extraperitoneal prothesis.Results All patients were operated on successfully.Average time was (33 ±12) min.Blood loss was (16 ±4) ml.Hospital stay was 7 - 12 d.7 patients repaired by ADM fully recovered.There were no chronic pain,paresthesia,pneumonia and urinary tract infection cases,no incision swelling,seroma or infection.All patients were followed up with median time of 14 months,ranging from 5 to 26 months.There were not hernia recurrence,nor surgical site infection during follow-up period.Conclusions For the repairing of abdominal complicated incisional hernia,the application of acellular dermal matrix is safe and effective method especially in those of incisional hernia complicated by infection. Key words: Hernia, ventral; Biocompatible materials; Acellular dermal matrix; Abdominal wall reconstruction