Open AccessPorcine acellular dermal matrix (PADM) vascularises after exposure in open necrotic wounds seen after complex hernia repair
Author(s) -
Gowda Arvind U,
Chang Sarah M.,
Chopra Karan,
Matthews Jamil A,
Sabino Jennifer,
Stromberg Jeffrey A,
Zahiri Hamid R,
Pinczewski Joel,
Holton Luther H,
Silverman Ronald P,
Singh Devinder P
Publication year - 2016
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.12558
Subject(s) - medicine , granulation tissue , surgery , debridement (dental) , wound healing , hernia , hernia repair , acellular dermis , implant
Biological alternatives to synthetic meshes are increasingly utilised in complex abdominal wall reconstruction. There is a lack of evidence demonstrating that non‐cross‐linked porcine acellular dermal matrix vascularizes and integrates with human tissue in suboptimal wound conditions. We aimed to evaluate these properties in Strattice™ (Life Cell Inc., Branchburg, NJ ) following ventral hernia repair. A retrospective review of patients with high‐risk ventral hernia repair utilising Strattice™ as an onlay after open component separation was conducted. Patients with postoperative wound exploration and exposure of the onlay were included in this review. One patient underwent punch biopsy for histological analysis. Eleven patients with wound complications necessitating postoperative debridement and exposure of Strattice™ onlay were identified. The onlay was partially debrided in two cases, and one case required complete excision. Vascularisation was clinically evident in 10 of 11 cases (91%) as demonstrated by the presence of granulation tissue and/or the ability to support a skin graft. Histological analysis of one onlay 3 months postoperatively showed neovascularisation and collagen remodelling with minimal inflammatory response. Strattice™ demonstrated resistance to rejection, ability to undergo vascularisation and incorporation into host tissues in sub‐optimal wound conditions following ventral hernia repair.