Faculty Collaboration Database

Long-term outcome of acellular dermal matrix when used for large traumatic open abdomen. J Trauma 2008 Aug;65(2):349-53

Date

08/13/2008

Pubmed ID

18695470

DOI

10.1097/TA.0b013e31817fb782

Scopus ID

2-s2.0-67649211100 (requires institutional sign-in at Scopus site)   80 Citations

Abstract

BACKGROUND: The purpose of this study is to prospectively examine the use of Human Acellular Dermal Matrix (HADM) in trauma patients with large open abdominal wounds and assess the long-term outcome. Previous studies have not examined the long-term outcomes in trauma patients with abdominal wall reconstructions.

METHODS: An institutional review board approved prospective case series of consecutive patients admitted to a level I university trauma center, who were unable to have their abdomen closed primarily after trauma laparotomy. These patients had HADM placed to attain closure of the abdomen with skin advancement flaps to cover the HADM when possible. Our primary outcome measure was hernia formation and our secondary outcomes were laxity, fistulae, and infections associated with HADM.

RESULTS: Ten patients were enrolled during a 1-year period. Mean time to HADM placement was 17.2 days +/- 3.6 days. Mean initial defect size was 425.1 cm2 +/- 75.9 cm2 with the largest 770 cm2. Thirty day follow-up showed no recurrence in 100% patients. Six patients remained for long-term follow-up. Follow-up at 60 days demonstrated significant laxity or recurrent hernia or both in 67% of patients, and this increased to 100% by the end of 1 year follow-up. There were no bowel fistulae in these patients closed with HADM but 20% with infection.

CONCLUSIONS: HADM is an alternative available to reconstruct the unclosable open abdomen with no fistulae formation, however, it is associated with a high rate of laxity in large abdominal wounds.

Author List

de Moya MA, Dunham M, Inaba K, Bahouth H, Alam HB, Sultan B, Namias N

Author

Marc Anthony De Moya MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdominal Injuries
Abdominal Wall
Adult
Aged
Collagen
Fasciotomy
Hernia, Ventral
Humans
Middle Aged
Prospective Studies
Skin, Artificial
Suture Techniques