Multi-institutional Experience Using Human Acellular Dermal Matrix for Ventral Hernia Repair in a Compromised Surgical Field

摘要: Background A complex ventral hernia repair (CVHR) involves a compromised surgical field where gastrointestinal, biliary, and genitourinary procedures are performed. Complex is significant problem in trauma, emergency, elective general surgery which prosthetic material contraindicated. In this clinical scenario, primary fascia closure carries 50% risk of developing hernia. The other option planned with delayed repair. Hypothesis Human acellular dermal matrix suitable implant for CVHR field. Design Multi-institutional, 5-year retrospective review. Setting Four academic medical centers. Patients Methods Each center obtained institutional review board approval. included the had undergone human matrix. Data collected age, body mass index (calculated as weight kilograms divided by height meters squared), comorbidities, size fascial defect, wound classification, hospital length stay, follow-up, mortality. Primary outcomes were site infection, fistula recurrence, recurrence. Both χ 2 logistic regression analyses Results Two hundred forty patients met study criteria. Their mean (SD) age was 52.2 (15.0) years, 132 (55.0%) men. most common comorbidity hypertension (115 [47.9%]), defect 201 cm . stay 17.2 days, follow-up 317 days. overall mortality 2.9%. recurrence rate 17.1% (41 patients). Repair or stoma associated ( P  = .03) Conclusions alternative less than that seen repair, offering additional improved options group patients. Stoma takedown at time continues to be complications.