Early Clinical Outcomes of a Novel Antibiotic-Coated, Non-Crosslinked Porcine Acellular Dermal Graft after Complex Abdominal Wall Reconstruction

详细信息    查看全文

• 作者：Erin H. Baker ; MD^a ; Darren Lepere ; MD^b ; Megan P. Lundgren ; MD^b ; Patrick J. Greaney ; MD ; FACS^b ; David A. Ehrlich ; MD^b ; Steven E. Copit ; MD^b ; Allison L. Murphree ; MD^c ; Anthony J. Canfield ; MD ; FACS^d ; Glenn Parker ; MD ; FACS^e ; David A. Iannitti ; MD ; FACS^a ; ^{David.Iannitti@carolinashealthcare.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：AWR ; abdominal wall reconstruction ; NCPADG ; non-crosslinked porcine acellular dermal graft ; VHR ; ventral hernia repair ; VHWG ; Ventral Hernia Working Group ; XenAB ; XenMatrix AB
• 刊名：Journal of the American College of Surgeons
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：223
• 期：4
• 页码：581-586
• 全文大小：204 K

文摘

Non-crosslinked porcine acellular dermal grafts (NCPADG) are currently the mainstay biomaterial for abdominal wall reconstruction (AWR) in complex hernia patients. We report early clinical outcomes using a novel rifampin/minocycline-coated NCPADG for AWR.

Study Design

A multi-institutional retrospective review was performed of patients who underwent ventral hernia repair using XenMatrix AB Surgical Graft (CR Bard, Inc [Davol]). Patient demographics, hernia and procedure characteristics, and surgical site occurrences/postoperative complications were reviewed up to 6 months after AWR.

Results

Seventy-four patients underwent AWR using XenMatrix AB Surgical Graft. Open AWR was performed in 52 patients (70.3%), and 22 patients (29.7%) underwent laparoscopic VHR. Median hernia size/area was 66.0 cm² (range 9.4 to 294.5 cm²). Sixteen patients (21.6%) had previous wound infections, and 16 patients (21.6%) had violation of the gastrointestinal tract during hernia repair. The most common locations of NCPADG placement were within the intraperitoneal (32.4%) and onlay (21.6%) positions, respectively. Median hospital length of stay was 4 days. Within 30 days after AWR, 6 (8.1%) patients were readmitted, postoperative seroma formation developed in 4 (5.4%) patients, 1 patient required percutaneous drainage, and surgical site infections developed in 5 (6.8%) patients. At 6 months follow-up, hernia recurrence had developed in 4 (5.4%) patients.

Conclusions

Data suggest that use of a novel rifampin/minocycline-coated NCPADG was associated with a low rate of postoperative surgical site occurrences/postoperative complications during the first 30 days of follow-up in complex AWR patients. In addition, data suggest a low rate of hernia recurrence at 6-month follow-up. Additional study is warranted to determine whether early antimicrobial protection of the device translates into longer-term protection of the repair.