Purpose: The reconstruction of abdominal wall defects in contaminated fields remains a surgical challenge. Hernia recurrence in this setting can be as high as 50%. Synthetic mesh is at increased risk for infection in contaminated wounds. We have studied the use of AlloDerm for abdominal wall reconstruction in contaminated wounds.

Methods and Materials: AlloDerm was used as an inlay to repair full thickness defects of the abdominal wall in the setting of enteric fistulas, stomas, bowel anastomosis, and infection.

Results: 35 abdominal wall defects were repaired in 30 patients. Indications included 12 ventral hernias, 6 parastomal hernias, and 17 stoma site defects. 9 patients had concurrent enterocutaneous fistulas. Average follow-up at present is 6.5 months (range 1-18 months) with six patients followed for more than one year. 22 patients healed without incident. 7 patients experienced delayed wound healing which resolved with local wound care. One suture abscess required removal of prolene sutures. No cases required removal of the AlloDerm.

Conclusions: The results, thus far, support the use of AlloDerm for closure of a wide variety of abdominal wall defects in contaminated wounds.