Wednesday, November 6, 2002 - 7:27 AM
436

Revascularization of Human Acellular Dermis Matrix When Used for Ventral Hernia Repair – A Rabbit Model

Nathan Gopi Menon, MD, Eduardo D. Rodriguez, DDS, MD, Nelson H. Goldberg, MD, and Ronald P. Silverman, MD.

Purpose: This study investigates if human acellular dermis (Alloderm, LifeCell Corp., Branchburg, NJ) revascularizes when used to reconstruct abdominal wall defects in rabbits. This could prove useful in infected situations where prosthetic mesh is suboptimal.

Methods: Abdominal wall defects were created in 25 rabbits. This defect was repaired with (A)Alloderm (n=10), (B)Goretex (W. L. Gore & Associates, Inc., Elkton, MD) (n=10), and (C) primary closure (n=5). The defect measured 3cm x 7cm in groups A and B, and 0.5cm x 7cm in group C. After 30 days the abdominal walls were analyzed for: presence of hernia, size of the implant, presence of intraabdominal adhesions, breaking-strength of implant-fascial interface with the suture removed, and neovascularization by fluorescein dye and histological analysis.

Results: There were no hernias in any of the groups. In 8 out of 10 of the Alloderm group, there was no change in implant size. The remaining 2 of the Alloderm group had < 1 cm of stretch in the horizontal dimension of the implant. Adhesions were seen in all of the rabbits in the Goretex group, but not in the other groups. There was no statistical (t test) difference between the mean breaking strength of the Alloderm-fascial interface (288.6N/mm2 +/- 97.1), and the Goretex-fascial interface (337.0 N/mm2+/- 141.2). Infusion with fluorescein dye and histology indicated abundant vascular ingrowth into the Alloderm.

Conclusions: This study indicates that in the rabbit, Alloderm does support vascular ingrowth when used for abdominal wall reconstruction and is as effective as Goretex in repairing ventral hernias at 30 days.


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