The use of human acellular dermal matrix for parastomal hernia repair in patients with inflammatory bowel disease: A novel technique to repair fascial defects

Timucin Taner, Robert R. Cima, David Larson, Eric Dozois, John H. Pemberton, Bruce G. Wolff

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

PURPOSE: Parastomal hernias occur frequently in patients with inflammatory bowel disease who require a stoma and are associated with high recurrence rates. The tissue weakness at the site of hernia can be overcome by creating neofascia using two separate layers of human acellular dermal matrix. METHODS: Thirteen consecutive patients with inflammatory bowel disease with symptomatic parastomal hernia underwent open parastomal hernia repair at an academic tertiary referral center whereby the posterior and anterior rectus fascia at the stoma site was reconstructed with human acellular dermal matrix. Patients were followed prospectively for 290 T 119 days (mean T standard deviation), and data were reviewed for rate of postoperative complications, hernia recurrence, and patient satisfaction. RESULTS: Mean operative time was 233 T 80 (range, 129Y355) minutes. No intraoperative complications occurred. Average hospital stay was 8.1 T 2.4 (range, 6Y14) days. Postoperative complications included seroma formation, incisional separation (2 patients each, 15.4 percent), and superficial wound infection (1 patient, 7.7 percent). There were two cases of asymptomatic hernia recurrence as determined by computerized tomography. These patients did not require any intervention. Overall patient satisfaction with the procedure was high. CONCLUSIONS: In patients with parastomal hernia, reconstruction of the stoma site and abdominal wall with human acellular dermal matrix seems to be safe and results in high patient satisfaction.

Original languageEnglish (US)
Pages (from-to)349-354
Number of pages6
JournalDiseases of the Colon and Rectum
Volume52
Issue number2
DOIs
StatePublished - Feb 2009

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Acellular Dermis
Herniorrhaphy
Inflammatory Bowel Diseases
Hernia
Patient Satisfaction
Recurrence
Seroma
Fascia
Intraoperative Complications
Abdominal Wall
Wound Infection
Operative Time
Tertiary Care Centers
Length of Stay
Tomography

Keywords

  • Alloderm
  • Inflammatory bowel disease
  • Parastomal hernia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "The use of human acellular dermal matrix for parastomal hernia repair in patients with inflammatory bowel disease: A novel technique to repair fascial defects",
abstract = "PURPOSE: Parastomal hernias occur frequently in patients with inflammatory bowel disease who require a stoma and are associated with high recurrence rates. The tissue weakness at the site of hernia can be overcome by creating neofascia using two separate layers of human acellular dermal matrix. METHODS: Thirteen consecutive patients with inflammatory bowel disease with symptomatic parastomal hernia underwent open parastomal hernia repair at an academic tertiary referral center whereby the posterior and anterior rectus fascia at the stoma site was reconstructed with human acellular dermal matrix. Patients were followed prospectively for 290 T 119 days (mean T standard deviation), and data were reviewed for rate of postoperative complications, hernia recurrence, and patient satisfaction. RESULTS: Mean operative time was 233 T 80 (range, 129Y355) minutes. No intraoperative complications occurred. Average hospital stay was 8.1 T 2.4 (range, 6Y14) days. Postoperative complications included seroma formation, incisional separation (2 patients each, 15.4 percent), and superficial wound infection (1 patient, 7.7 percent). There were two cases of asymptomatic hernia recurrence as determined by computerized tomography. These patients did not require any intervention. Overall patient satisfaction with the procedure was high. CONCLUSIONS: In patients with parastomal hernia, reconstruction of the stoma site and abdominal wall with human acellular dermal matrix seems to be safe and results in high patient satisfaction.",
keywords = "Alloderm, Inflammatory bowel disease, Parastomal hernia",
author = "Timucin Taner and Cima, {Robert R.} and David Larson and Eric Dozois and Pemberton, {John H.} and Wolff, {Bruce G.}",
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T1 - The use of human acellular dermal matrix for parastomal hernia repair in patients with inflammatory bowel disease

T2 - A novel technique to repair fascial defects

AU - Taner, Timucin

AU - Cima, Robert R.

AU - Larson, David

AU - Dozois, Eric

AU - Pemberton, John H.

AU - Wolff, Bruce G.

PY - 2009/2

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N2 - PURPOSE: Parastomal hernias occur frequently in patients with inflammatory bowel disease who require a stoma and are associated with high recurrence rates. The tissue weakness at the site of hernia can be overcome by creating neofascia using two separate layers of human acellular dermal matrix. METHODS: Thirteen consecutive patients with inflammatory bowel disease with symptomatic parastomal hernia underwent open parastomal hernia repair at an academic tertiary referral center whereby the posterior and anterior rectus fascia at the stoma site was reconstructed with human acellular dermal matrix. Patients were followed prospectively for 290 T 119 days (mean T standard deviation), and data were reviewed for rate of postoperative complications, hernia recurrence, and patient satisfaction. RESULTS: Mean operative time was 233 T 80 (range, 129Y355) minutes. No intraoperative complications occurred. Average hospital stay was 8.1 T 2.4 (range, 6Y14) days. Postoperative complications included seroma formation, incisional separation (2 patients each, 15.4 percent), and superficial wound infection (1 patient, 7.7 percent). There were two cases of asymptomatic hernia recurrence as determined by computerized tomography. These patients did not require any intervention. Overall patient satisfaction with the procedure was high. CONCLUSIONS: In patients with parastomal hernia, reconstruction of the stoma site and abdominal wall with human acellular dermal matrix seems to be safe and results in high patient satisfaction.

AB - PURPOSE: Parastomal hernias occur frequently in patients with inflammatory bowel disease who require a stoma and are associated with high recurrence rates. The tissue weakness at the site of hernia can be overcome by creating neofascia using two separate layers of human acellular dermal matrix. METHODS: Thirteen consecutive patients with inflammatory bowel disease with symptomatic parastomal hernia underwent open parastomal hernia repair at an academic tertiary referral center whereby the posterior and anterior rectus fascia at the stoma site was reconstructed with human acellular dermal matrix. Patients were followed prospectively for 290 T 119 days (mean T standard deviation), and data were reviewed for rate of postoperative complications, hernia recurrence, and patient satisfaction. RESULTS: Mean operative time was 233 T 80 (range, 129Y355) minutes. No intraoperative complications occurred. Average hospital stay was 8.1 T 2.4 (range, 6Y14) days. Postoperative complications included seroma formation, incisional separation (2 patients each, 15.4 percent), and superficial wound infection (1 patient, 7.7 percent). There were two cases of asymptomatic hernia recurrence as determined by computerized tomography. These patients did not require any intervention. Overall patient satisfaction with the procedure was high. CONCLUSIONS: In patients with parastomal hernia, reconstruction of the stoma site and abdominal wall with human acellular dermal matrix seems to be safe and results in high patient satisfaction.

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