生物假体是小儿高危腹壁缺损重建的一种可行选择。

The biological prosthesis is a viable option for abdominal wall reconstruction in pediatric high risk defects.

作者信息

Zmora Osnat, Castle Shannon L, Papillon Stephanie, Stein James E

机构信息

Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.

出版信息

Am J Surg. 2017 Sep;214(3):479-482. doi: 10.1016/j.amjsurg.2017.01.004. Epub 2017 Jan 6.

DOI:10.1016/j.amjsurg.2017.01.004

PMID:28093117

Abstract

BACKGROUND

Our aim was to explore the indications for and outcome of biological prostheses to repair high risk abdominal wall defects in children.

METHODS

A retrospective chart review was performed of all cases of abdominal wall reconstruction in a single institution between 2007 and 2015. Demographic and clinical variables, technique and complications were described and compared between prosthesis types.

RESULTS

A total of 23 patients underwent abdominal wall reconstruction using a biological prosthesis including 17 neonates. The main indication was gastroschisis (17 patients) followed by ruptured omphalocele and miscellaneous conditions. Alloderm™ was most commonly used followed by Surgisis™, Strattice™, Flex-HD™ and Permacol™. In 22 cases wounds were contaminated or infected. Open bowel/stomas were present in 9 cases. Skin was not closed in 11 cases. Post-operative complication rate was 30% and hernia recurrence rate was 17% after a mean follow-up time of 16 months.

CONCLUSIONS

The use of a biological prosthesis may offer advantages over a synthetic mesh in pediatric high risk abdominal wall defects. The surgeon should be ready to consider its use in selected cases.

摘要

背景

我们的目的是探讨生物假体修复儿童高危腹壁缺损的适应证及疗效。

方法

对2007年至2015年期间单一机构内所有腹壁重建病例进行回顾性病历审查。描述并比较了不同假体类型之间的人口统计学和临床变量、技术及并发症情况。

结果

共有23例患者使用生物假体进行腹壁重建，其中包括17例新生儿。主要适应证为腹裂（17例患者），其次为脐膨出破裂及其他情况。最常用的是Alloderm™，其次是Surgisis™、Strattice™、Flex-HD™和Permacol™。22例伤口存在污染或感染。9例存在开放性肠管/造口。11例未缝合皮肤。平均随访16个月后，术后并发症发生率为30%，疝复发率为17%。