Saman M, Kadakia S, Ducic Y. Does the use of an acellular dermal graft in abdominal closure after rectus flap harvest impact the occurrence of post-operative hernia?
Oral Maxillofac Surg 2015;
19:347-51. [PMID:
25910994 DOI:
10.1007/s10006-015-0498-1]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 04/16/2015] [Indexed: 12/01/2022]
Abstract
IMPORTANCE
Patients with rectus free flap harvest extending below the arcuate line are predisposed to postoperative hernia formation. As such, many authors have advocated the use of closure adjuncts to increase the integrity of the closure and prevent hernia or abdominal wall bulging.
SETTING
Busy level 1 public trauma center in metropolitan Fort Worth, Texas
INTERVENTIONS
Following harvest of the rectus free flap, 48 patients underwent primary closure; 24 of these patients had defects extending below the arcuate line. Forty patients were closed with an acellular dermal graft; 22 of these patients had defects extending below the arcuate line.
MAIN OUTCOME MEASURE
Postoperative hernia formation and local infection rate were examined in a minimum follow-up period of 1 year.
RESULTS
Regardless of closure method, no hernias were observed in the postoperative period. Using an unpaired t test and an alpha value of 0.05, there was no statistically significant difference in the infection rate between the two groups.
CONCLUSION
Following rectus abdominis myocutaneous free flap harvest, the use of an acellular dermal graft in abdominal wall closure may not be of any further advantage in the prevention of hernia.
LEVEL OF EVIDENCE
Retrospective (Level III).
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