Use of human acellular dermal matrix for abdominal wall reconstructions.

Background: Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects.

Methods: We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications.

Results: Postoperative wound infections, noninfectious wound complications, and recurrences developed in 35%, 44%, and 41% of patients, respectively. No patients required ADM removal. Long surgical times (> or =300 min), implants of 100 cm(2) or greater, and repairs using 3 or more ADM sheets were associated significantly with the development of a postoperative wound infection. The approximation of ADM directly to the fascial edge (P = .02), long surgical time (P < .01), implant size of 100 cm(2) or greater (P = .01), and the presence of a postoperative wound infection (P = .02) were associated significantly with recurrence.

Conclusions: Recurrences and complications after ADM fascial repairs may be higher than previously reported and associated with implant size and method of implantation. Postoperative infection, although not necessitating implant removal, is associated with more recurrences.