Aycock Joyce, Fichera Alessandro, Colwell Janice C, Song David H
Department of Surgery, University of Chicago Medical Center, Illinois, USA.
J Wound Ostomy Continence Nurs. 2007 Sep-Oct;34(5):521-3. doi: 10.1097/01.WON.0000290731.38817.ed.
Treatment of parastomal hernia is often complicated by a high recurrence rate and likelihood of wound contamination. We reported an initial series of parastomal hernia repairs performed with acellular dermal matrix.
We reviewed a series of 11 patients who had parastomal hernia repairs with acellular dermal matrix and recorded the type of ostomy, previous repair, associated intestinal pathology, type of repair performed, perioperative complications, and rate of recurrence.
Between 2004 and 2006, 11 patients underwent parastomal hernia repair with acellular dermal matrix by the senior author. Nine of 11 patients had associated Crohn's disease or ulcerative colitis and 3 had recurrent parastomal hernias that had failed initial repair. Mean follow-up was 8.7 months (range: 1-21 months). Two patients developed wound infections that did not require implant removal and healed with local wound care. Three patients developed recurrent hernias.
Parastomal hernia with acellular dermal matrix results in recurrence rates comparable to those reported in the literature for synthetic mesh repair. It offers the advantages of avoiding stoma relocation and of not requiring implant removal in cases of wound infection.
