Restoring Abdominal Wall Integrity in Contaminated Tissue-Deficient Wounds Using Autologous Fascia Grafts

The use of porcine small intestinal submucosa as a prosthetic material for laparoscopic hernia repair in infected and potentially contaminated fields: long-term follow-up

“…The surgical treatment of recurrent abdominal wall hernias in a contaminated field specially associated with infected mesh poses a significant challenge to the surgeon, as previously pointed by Silverman et al in a report of a series of cases of hernia repairs in contaminated tissue-deficient wounds using autologous fascia and Alloderm to reinforce or bridge larger defects, where he preferred biologically bioabsorbable active prostheses over synthetic nonabsorbable prosthetic materials [10]. Similarly, Szczerba S et al, in a trial including 11 patients undergoing definitive surgical treatment of infected exposed ventral hernia mesh, propose autogenous flap reconstruction for these cases in preference over nonabsorbent materials.…”

Acellular cadaveric dermis (Alloderm) for ventricular coverage after a gunshot wound

“…2 The abscence of inflammation in Alloderm, in contrast to other synthetic materials, has been reported in animal models. 12,14,15 There is no significant difference in tensile strength or attenuation between Alloderm and other synthetic materials such as polytetrafluoroethylene patch (PTFE). Alloderm has been used in adults for repair of large ventral hernias and as a fascial substitute in contaminated fields.…”

Abdominal wall reconstruction

“…Contaminated wound beds are poor candidates for prosthetic mesh placement secondary to high rates of mesh infection, fistula formation, and extrusion. 2,3 In such a setting, biologic material, such as acellular, human, or porcine dermal matrices may be used as an alternative. 5,6 When placed between the abdominal wall and underlying bowel, animal studies have demonstrated a decrease incidence of abdominal adhesions.…”