Liu Feide, Li Liye, Zhu Yingmei, Yao Sheng, Wang Shibin
Department of General Surgery, First Affiliated Hospital, General Hospital of Chinese PLA, Beijing 100048, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Oct;24(10):1253-6.
To summarize the clinical effect of allogenic acellular dermal matrix in repair of abdominal wall hernia and defect.
The clinical data were analyzed retrospectively from 31 patients with abdominal wall hernia and defect repaired by allogenic acellular dermal matrix between March 2007 and November 2009. There were 19 males and 12 females with an age range of 10-70 years (median, 42 years), including 6 abdominal wall defects caused by abdominal wall tumor resection, 4 patches infection after abdominal wall hernia repair using prosthetic mesh, 2 incisional hernia, 1 parastomal hernia, 1 recurrent parastomal hernia receiving mesh repair, 1 mesh infection caused by parastomal hernia repair using prosthetic patch, 3 mesh infection caused by tension free inguinal after hernia repair, and 13 inguinal hernia. There were 12 patients with contaminated or infectious wound. The disease duration was from 1 to 34 months (6 months on average). The defect size of abdominal wall ranged from 6 cm x 4 cm to 19 cm x 10 cm. Abdominal wall hernia or defect underwent repair using allogenic acellular dewall matrix.
Of the 31 patients, 29 patients recovered with primary wound healing. Chronic sinus tract occurred in 1 patient and the wound was cured by change dressing. Wound dehiscence and patch exposure occurred in 1 patient, and second healing was achieved after change dressing. All the 31 patients were followed up 6-36 months, no abdominal wall hernia or hernia recurrence occurred in other patients except 1 patient who had abdominal bulge. And no foreign body sensation or chronic pain in wound area occurred.
It is feasible and safe to use allergenic acellular dermal matrix patch for repair of abdominal wall hernia or soft tissue defect, especially in contaminated or infectious wound.
总结同种异体脱细胞真皮基质修复腹壁疝及缺损的临床效果。
回顾性分析2007年3月至2009年11月间采用同种异体脱细胞真皮基质修复的31例腹壁疝及缺损患者的临床资料。其中男19例，女12例，年龄10 - 70岁（中位数42岁），包括腹壁肿瘤切除术后腹壁缺损6例，人工补片修补腹壁疝后补片感染4例，切口疝2例，造口旁疝1例，造口旁疝复发再次行补片修补1例，造口旁疝人工补片修补后补片感染1例，无张力腹股沟疝修补术后补片感染3例，腹股沟疝13例。伤口污染或感染患者12例。病程1 - 34个月（平均6个月）。腹壁缺损大小为6 cm×4 cm至19 cm×10 cm。采用同种异体脱细胞真皮基质修复腹壁疝或缺损。
31例患者中，29例患者伤口一期愈合康复。1例患者出现慢性窦道，经换药后伤口愈合。1例患者伤口裂开、补片外露，换药后二期愈合。31例患者均随访6 - 36个月，除1例患者出现腹部膨隆外，其余患者均未发生腹壁疝或疝复发。伤口区域无异物感或慢性疼痛。
同种异体脱细胞真皮基质补片用于修复腹壁疝或软组织缺损是可行且安全的，尤其适用于污染或感染伤口。
