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Ventral hernia repair using allogenic acellular dermal matrix in a swine model

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Abstract

Background

This study was designed to assess the long-term efficacy of allogenic acellular dermal matrix (ADM) used as an interpositional graft for ventral hernia repair in a swine model.

Methods

We created 12×4-cm full-thickness abdominal wall defects in 22 Yucatan miniature pigs. The defect was repaired with either two 6×4-cm pieces of AlloDerm (acellular dermal matrix processed from pig skin in order to avoid a xenogenic response, LifeCell Corporation, Branchburg, NJ USA) (n=12), or expanded polytetrafluoroethylene mesh (ePTFE) (Gore-Tex, W.L. Gore & Associates, Inc., Newark, DE USA) (n=10). In six pigs, a separate 3-cm fascial incision was made, which was then suture repaired as a control for tensiometry testing. The surgical sites were evaluated at either 3 months or 9 months for the presence of a hernia, stretching of the implant, adhesions, vascularity, and biomechanical strength.

Results

Two hernias occurred in both the ADM and the ePTFE groups. There was minimal stretching of the implants and minimal adhesions in both groups. Fluorescein testing and histology indicated vascular ingrowth into the ADM. There was no statistical difference between the mean breaking strengths of the ADM-fascial interface (106.5 N±SD 40.1), the interface between two pieces of ADM (149.1 N±SD 76.7), and the primary fascial repair (108.1 N±SD 20.9) at 9 months. The ADM-fascial interface had a significantly higher breaking strength than that of the ePTFE-fascia interface (66.1 N±SD 30.1) (P=0.017, t-test, P=0.043 Wilcoxon rank sum test).

Conclusions

In this study, we were unable to demonstrate a difference between ADM and ePTFE in their ability to repair ventral hernias at 9 months in a swine model. The ADM additionally supports vascular ingrowth and exhibits increased breaking strength at the fascia-implant interface.

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Authors and Affiliations

  1. University of Maryland Division of Plastic Surgery, University of Maryland Medical Center, 22 S. Greene St., Baltimore, MD 21201 , USA

    R. P. Silverman, E. N. Li, L. H. Holton III & N. H. Goldberg

  2. Division of Plastic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    K. T. Sawan

Authors
  1. R. P. Silverman
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  2. E. N. Li
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  3. L. H. Holton III
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  4. K. T. Sawan
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  5. N. H. Goldberg
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Corresponding author

Correspondence to R. P. Silverman.

Additional information

This paper won the Fruchaud prize for best poster presentation at the American Hernia Society meeting in Orlando, Fla., USA, on February 27, 2004.

This study was funded in part by an unrestricted donation to the University of Maryland Division of Plastic Surgery research fund from LifeCell Corporation. Dr. Ronald P. Silverman also has received honoraria from LifeCell Corporation as a speaker.

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Silverman, R.P., Li, E.N., Holton, L.H. et al. Ventral hernia repair using allogenic acellular dermal matrix in a swine model. Hernia 8, 336–342 (2004). https://doi.org/10.1007/s10029-004-0241-6

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  • DOI: https://doi.org/10.1007/s10029-004-0241-6

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