人尸体脱细胞真皮在腹部疝修复中的应用。
Utilization of human cadaveric acellular dermis for abdominal hernia reconstruction.
作者信息
Espinosa-de-los-Monteros Antonio, de la Torre Jorge I, Marrero Ian, Andrades Patricio, Davis Michael R, Vásconez Luis O
机构信息
Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
出版信息
Ann Plast Surg. 2007 Mar;58(3):264-7. doi: 10.1097/01.sap.0000254410.91132.a8.
BACKGROUND
Incisional hernias with history of recurrence or infection remain a challenge, with high postoperative morbidity and recurrence rates. The purpose of this study is to evaluate outcomes of patients treated with human cadaveric acellular dermis as an adjunct to abdominal wall reconstruction.
METHODS
We retrospectively reviewed 39 abdominal wall reconstructions with human cadaveric acellular dermis performed in 37 patients and compared them with 39 randomly selected cases.
RESULTS
There is a significant decrease in recurrence rates when human cadaveric acellular dermis is added as an overlay to primary closure plus rectus muscle advancement and imbrication in patients with medium-sized hernias. No differences were observed when adding human cadaveric acellular dermis as an overlay to patients with large-size hernias treated with underlay mesh. The use of human cadaveric acellular dermis did not increase postoperative morbidity rates.
CONCLUSIONS
Improved results with human cadaveric acellular dermis are obtained by achieving tension-free repairs.
背景
有复发或感染史的切口疝仍然是一个挑战，术后发病率和复发率都很高。本研究的目的是评估将人尸体脱细胞真皮作为腹壁重建辅助材料治疗患者的效果。
方法
我们回顾性分析了37例患者接受的39次用人尸体脱细胞真皮进行的腹壁重建手术，并将其与39例随机选择的病例进行比较。
结果
对于中型疝患者，在初次缝合加腹直肌推进和重叠缝合的基础上加用人尸体脱细胞真皮作为覆盖物时，复发率显著降低。对于采用补片植入法治疗的大型疝患者，加用人尸体脱细胞真皮作为覆盖物时未观察到差异。使用人尸体脱细胞真皮并未增加术后发病率。
结论
通过实现无张力修复，用人尸体脱细胞真皮可取得更好的效果。
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