The combined application of human acellular dermal matrix and vacuum wound drainage on incarcerated abdominal wall hernias

PURPOSE: Complex contaminated or infected abdominal wall defects present a particularly challenging problem to the surgeon. The aim of this study was to describe our experience with human acellular dermal matrix (ADM) in incarcerated abdominal wall herniorrhaphy. METHODS: We retrospectively reviewed data from 63 patients (51 males and 12 females) who underwent emergency surgery for acute incarcerated abdominal wall hernias with ADM repair, between June 2008 and October 2011 at Beijing Chaoyang Hospital, Capital Medical University. RESULTS: All hernias were repaired with an intraperitoneal underlay repair and received a high-vacuum wound drainage system after herniorrhaphy. 19 patients underwent reinforced repair with component separation. Over a median follow-up period of 32 (range 13-58) months, the recurrence rate was 4.8%. Two patients developed bulges, one developed a hematoma, one developed a seroma, and one had a superficial wound infection. No patients developed fistulae, intestinal obstruction, abdominal pain, or stiffness of the abdominal wall postoperatively. CONCLUSION: Our study suggests that the use of ADM as a biological mesh combined with high-vacuum wound drainage system in complex abdominal wall reconstruction is acceptable without major side effects.