Abdominal Wall Allograft
| Autor: | Patrick S. Cottler, David B. Drake, Angela Pineros-Fernandez, Raymond F. Morgan, Brent R. DeGeorge, Jonathan Bryce Olenczak |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030230 surgery Sensitivity and Specificity Abdominal wall 03 medical and health sciences 0302 clinical medicine Anterior rectus sheath Tensile Strength Ultimate tensile strength Cadaver medicine Humans Acellular Dermis Fascia Reduction (orthopedic surgery) Aged Aged 80 and over Decellularization business.industry Abdominal Wall Abdominal wall reconstruction Middle Aged Plastic Surgery Procedures Allografts Biomechanical Phenomena Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Tissue and Organ Harvesting Composite Tissue Allografts Cadaveric spasm business |
| Zdroj: | Annals of Plastic Surgery. 78:S315-S321 |
| ISSN: | 0148-7043 |
| DOI: | 10.1097/sap.0000000000001029 |
| Popis: | INTRODUCTION Acellular dermal matrices have revolutionized abdominal wall reconstruction; however, device failure and hernia recurrence remain significant problems. Fascia grafts are a reconstructive adjunct with increased tensile strength compared with acellular dermal matrices; however, clinical use is limited by insufficient donor material and donor site morbidity. To this end, we investigate the biomechanical properties of human abdominal wall allografts (AWAs) consisting of the anterior rectus sheath from xiphoid to pubis. METHODS After cadaveric procurement of 6 human AWAs, the tissue was divided horizontally and a matched-sample study was performed with specimens randomized to 2 groups: fresh, unprocessed versus processed with gamma irradiation and decellularization. Specimens were evaluated for physical properties, DNA content, tensile strength, and electron microscopy. RESULTS All AWA donors were male, with a mean age of 55.2 years (range, 35-74 years). Procured AWAs had a mean length of 21.70 ± 1.8 cm, width of 14.30 ± 1.32 cm, and area of 318.50 cm, and processing resulted in a 98.3% reduction in DNA content. Ultimate tensile strength was significantly increased after tissue processing, and after subcutaneous implantation, processed AWA demonstrated 4-fold increased tensile strength compared with unprocessed AWAs. CONCLUSIONS Acellular AWAs represent a novel reconstructive adjunct for abdominal wall reconstruction with the potential of replacing "like with like" without additional donor site morbidity or antigenicity. |
| Databáze: | OpenAIRE |
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