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Abdominal Wall Reconstruction
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 AlloDerm— Supports restoration of structure, function and physiology in Abdominal Wall Repair
- AlloDerm is increasingly becoming recognized as an efficacious option for challenging hernia repair cases, particularly in contaminated and infected surgical sites.5,7,8,9
- AlloDerm has also been demonstrated to be an excellent option for patients with previous hernia surgeries & recurrences; patients with complications related to synthetic mesh; and patients with co-morbid conditions that may complicate and jeopardize the healing process.1,5,7,8,9 Some of these co-morbid conditions include:
- Obesity
- Smoking
- Diabetes
- Recurrence
- Malnutrition
Hernia repair presents the surgeon with a difficult task, particularly in patients with co-morbid conditions such as obesity, smoking, diabetes, recurrence and malnutrition. The abdominal wall protects vital intra-abdominal organs, so repairs must be able to withstand significant pressure while remaining flexible.
Flexible, strong, infection-resistant and versatile enough to be used in a variety of applications, AlloDerm is an excellent alternative to synthetics for hernia repair. An increasing number of surgeons are discovering that AlloDerm provides improved outcomes in their most challenging cases, particularly those in which infection, hernia recurrence and significant loss of abdominal fascia may create surgical complications.
What makes AlloDerm an excellent option for challenging abdominal wall repairs? The answer lies in the benefits AlloDerm provides:
Fewer complications than synthetics
The use of synthetic mesh in hernia repair has been associated with a multitude of complications including infection, adhesion formation, erosion, extrusion, fistula formation, seroma/hematoma, foreign body reaction and hernia recurrence.5,7,9 Such complications can lead to failure of the repair—and ultimately the need for more complex and costly surgeries. In a retrospective analysis of 149 consecutive clinical cases, AlloDerm exhibited lower complication rates than synthetic mesh, as the bar graph shows. Additionally, the use of AlloDerm may reduce the patient's length of hospital stay and associated medical costs.1,9,12,13
Source: Buinewicz B, et al. LifeCell Clinical Monograph Series. 2003
Strong & intact with excellent handling properties
AlloDerm undergoes a proprietary, non-damaging process that ensures the biochemical components critical to tissue regeneration remain intact. AlloDerm is non-crosslinked because it is not exposed to any denaturing or damaging chemicals or processes. Additionally, AlloDerm provides the strength and durability required in challenging abdominal wall applications, and has been shown to exhibit superior suture retention strength when compared to other commercially available biological materials. AlloDerm also demonstrates excellent handling properties for intraoperative manipulation, sizing, shaping and suturing, ensuring a strong and lasting repair.2,3,6,
Source: Choe JM, et al. Urology. 2001
Source: Silverman RP, et al. Hernia. 2004
Note: The AlloDerm used in this study was processed from porcine skin in the exact fashion that LifeCell processes human-derived tissue grafts; the porcine-derived AlloDerm was implanted into pigs in order to avoid a xenogenic response.
Supports rapid revascularization, which can minimize the risk of infection
Published data in the peer-reviewed literature repeatedly demonstrate that AlloDerm supports rapid revascularization, which contributes to its resistance to infection. AlloDerm supports rapid revascularization through existing vascular channels and new blood vessel formation, which also allows white blood cells to migrate to the surgical site. In published clinical studies, AlloDerm has been successfully utilized in contaminated and infected sites, with a very low incidence of implant removal.4,5,7,8,9
Allows for local treatment in the setting of infection or exposure
In the event that the AlloDerm becomes exposed due to wound dehiscence or skin breakdown, the AlloDerm can be treated locally without removal in most cases, minimizing the likelihood of additional surgical procedures and the resulting soft tissue loss.9,10
Resistant to adhesion formation
Because AlloDerm does not stimulate a foreign body response, there is minimal adhesion formation to the AlloDerm. This minimizes complications such as bowel obstructions and fistula formations; allows for simpler future surgeries in the abdominal area; and minimizes post-operative pain.4,6,11
Procedures
Since 2002, AlloDerm has been used in the repair of thousands of challenging abdominal wall defects, including:
- Replacement of infected mesh
- Contaminated wounds near the bowel
- Reinforcement for hernias, TRAM flap donor sites and stomas
- Hiatal hernia repair
- Paraesophageal hernia repair
- Parastomal hernia repair
- Umbilical hernia repair
- Traumatic fascia loss
- Management of open abdomen following abdominal compartment syndrome
Case Studies: Over 1 million successful implants and grafts to date in burn, periodontal, head and neck, and reconstructive procedures
The best evidence of AlloDerm’s efficacy comes from many surgeons who have used it successfully in some of their most difficult cases. An increasing number of these surgeons are publishing their clinical results: http://www.lifecell.com/media/70/
Product Selection
AlloDerm has the natural elasticity of human tissue. When used for hernia repair, AlloDerm should be sutured intraoperatively under significant tension after proper rehydration; based on surgeons' experience, removing the laxity of AlloDerm will expand the surface area coverage of each piece used by up to 50%.
AlloDerm is available in multiple sizes, enabling surgeons to purchase the precise amount and thickness needed for each procedure. The following sizes are those most commonly used for abdominal wall reconstruction:
| Product Code | Nominal Size | AlloDerm w/ 50% Expansion | Surface Area Coverage | Thickness** | | 102320 | 16 x 20 cm | 19 x 25 cm | 475 cm2 | Thick | | 982320 | 16 x 20 cm | 19 x 25 cm | 475 cm2 | X-Thick | | 102144 | 12 x 12 cm | 14.25 x 15 cm | 214 cm2 | Thick | | 982144 | 12 x 12 cm | 14.25 x 15 cm | 214 cm2 | X-Thick | | 102128 | 8 x 16 cm | 10 x 19 cm | 190 cm2 | Thick | | 982128 | 8 x 16 cm | 10 x 19 cm | 190 cm2 | X-Thick | | 102196 | 6 x 16 cm | 7.5 x 19 cm | 143 cm2 | Thick | | 982196 | 6 x 16 cm | 7.5 x 19 cm | 143 cm2 | X-Thick |
102082 | 4 x 16 cm | 5 x 19 cm | 95 cm2 | Thick | | 982080 | 4 x 16 cm | 5 x 19 cm | 95 cm2 | X-Thick | | 102096 | 8 x 12 cm | 10 x 14 cm | 140 cm2 | Thick | | 982096 | 8 x 12 cm | 10 x 14 cm | 140 cm2 | X-Thick | 102072 | 6 x 12 cm | 7.5 x 14 cm | 105 cm2 | Thick | | 982070 | 6 x 12 cm | 7.5 x 14 cm | 105 cm2 | X-Thick | | 102062 | 5 x 10 cm | 6 x 12.5 cm | 75 cm2 | Thick | | 982060 | 5 x 10 cm | 6 x 12.5 cm | 75 cm2 | X-Thick |
102050 | 4 x 12 cm | 5 x 14 cm | 70 cm2 | Thick | | 982048 | 4 x 12 cm | 5 x 14 cm | 70 cm2 | X-Thick |
**Thick: 0.79 - 2.03 mm (0.031 - 0.080 inches)
**X-Thick: 2.06 - 3.30 mm (0.081 - 0.130 inches)
Your LifeCell representative can help with the correct selection. To order AlloDerm, click here or call our toll-free LifeCell Customer Support Line at 800-367-5737.
References:
- Buinewicz B et al, The use of human acellular tissue matrix in abdominal wall reconstruction - A clinical perspective. LifeCell Clinical Monograph Series. 2003.
- Barber FA, et al. Tendon augmentation grafts: Biomechanical failure loads and failure patterns. Arthroscopy. 2006; 22(5): 534-538.
- Choe JM, et al. Autologous, cadaveric and synthetic materials used in sling surgery: Comparative biomechanical analysis. Urology. 2001; 58(3): 482-486.
- Menon NG, et al. Revascularization of human acellular dermis in full-thickness abdominal wall reconstruction in the rabbit model. Ann Plast Surg. 2003; 50: 523-527.
- Patton JH Jr, et al. Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions Am J Surg. 2007 Mar;193(3):360-3; discussion 363.
- Silverman RP et al, Ventral hernia repair using allogenic acellular dermal matrix in a swine model. Hernia 2004; 8(4): 336-342.
- Diaz JJ Jr, et al. Acellular Dermal Allograft for Ventral Hernia Repair in the Compromised Surgical Field. Am Surg. 2006 Dec;72(12):1181-1188
- Kim H, et al. Acellular dermal matrix in the management of high-risk abdominal wall defects. Am J Surg. 2006 Dec; 192(6): 705-9.
- Butler CE, et al. Pelvic, Abdominal, and Chest Wall Reconstruction with AlloDerm in Patients at Increased Risk for Mesh-Related Complications. Plast Reconstr Surg. 2005 Oct;116(5):1263-1275; discussion 1276-1277.
- Kish KJ, et al. Acellular Dermal Matrix (AlloDerm): New Material in the Repair of Stoma Site Hernias. Am Surg. 2005 Dec;71(12): 1047-50
- Butler CE, et al. Reduction of adhesions with composite AlloDerm/polypropylene mesh implants for abdominal wall reconstruction. Plast Reconstr Surg. 2004; 114(2): 464-473.
- Buinewicz B, et al. Acellular cadaveric dermis (AlloDerm): A new alternative for abdominal hernia repair. Ann Plast Surg. 2004; 52(2): 188-194.
- Kaleya RN, et al. Use of a global economic model to analyze the cost-benefit of AlloDerm in ventral hernia repair. LifeCell Clinical Monograph Series. 2005.
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