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Complex Abdominal Wall Reconstruction Using Repriza Acellular Dermal Matrix: A Retrospective Review of 47 Patients

Walter J. Joseph MD, Francesco M. Egro MBChB, MSc, MRCS, Aaron M. Foglio BS, Elizabeth M. Kenny BS, Ernest K. Manders MD, Brian S. Zuckerbraun MD
University
2018-02-14

Presenter: Elizabeth Kenny

Affidavit:
Vu. T. Nguyen

Director Name: Vu. T. Nguyen

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

Background: Large abdominal wall hernias remain a challenging problem involving patients with significant comorbidities and surgical treatments with inherent complications. Despite the advances in complex abdominal wall reconstruction (CAWR), the current synthetic and biologic meshes remain unsatisfactory. We aimed to determine the safety, efficacy, and complication profile using Repriza (Promethean LifeSciences, Inc.) acellular dermal matrix (ADM) for CAWR.

Methods: An IRB-approved retrospective cohort study of patients undergoing CAWR using Repriza ADM inserted using underlay and bridging techniques was performed between 2012 and 2017. Patient demographics, co-morbidities, operative and post-operative details were collected. Outcomes were analyzed using multivariable logistic regression.

Results: A total of 47 patients (70.2% female, 29.8% male) with a mean age of 58±12 years underwent CAWR with Repriza ADM. The significant pre-morbid state of our cohort was highlighted by a BMI of 32±7 and a high percentage of patients scoring ASA > 2 (70.2%) with significant cardiac (72.3%), respiratory (55.3%), diabetic (36.2%), and smoking histories (27.7%). Most patients had prior hernia repair (89.4%), with 34.0% having prior reinforcement of an abdominal wall defect. The majority of patient cases were designated as clean (76.6%) with only 12.8% needing enterotomy (clean-contaminated). Postoperative complications included seroma (12.8%), superficial wound infection (12.8%), dehiscence (12.8%), and DVT/PE (6.4%). Hernia recurrence through Repriza was 10.6% and de novo hernia recurrence was 10.6%.

Conclusion: Repriza is a novel, safe, and effective alternative for hernia repair and CAWR, demonstrated by low hernia recurrence rate and comparable complication profile with respect to other biologic mesh products.

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