Open Abdomen Management With Human Acellular Dermal Matrix in Liver Transplant Recipients

被引:21
作者
Singh, M. K. [1 ]
Rocca, J. P. [1 ]
Rochon, C. [1 ]
Facciuto, M. E. [1 ]
Sheiner, P. A. [1 ]
Rodriguez-Davalos, M. I. [1 ]
机构
[1] Westchester Med Ctr, Dept Hepatobiliary & Liver Transplant, Valhalla, NY USA
关键词
D O I
10.1016/j.transproceed.2008.06.105
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Abdominal wall closure after liver transplantation is not always feasible and may result in increased intra-abdominal pressure along with associated complications. Various temporary Closure techniques as well as open wound management have been used to address this complex problem. The aim of this series was to describe an approach to definitive wound closure of the open abdomen in liver transplant patients. Methods. We performed a retrospective review of all liver transplant patients at our institution from September 2005 to November 2007. The management of the open abdomen in 10 liver transplant patients was reviewed, and a novel approach described to manage these defects. Results. Ten patients with open wounds were closed during the study period using human acellular dermal matrix (HADM). There were 7 men and 3 women of median age 55 years. Average size of HADM was 235 cm(2). The median follow-up is,10 months with no incidence of evisceration or hernia. In 1 patient, the graft failed along the lateral side due to infection; it dislodged during vacuum-assisted closure dressing change in another patient at 5 months after closure. Fascial closure was not possible due to organ edema (n = 3), a large liver (n = 4) or wound infection with dehiscence (n = 3). Conclusions. RADM can be used for primary wound closure in both clean and contaminated wounds as an alternative to an open abdomen post-liver transplantation.
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页码:3541 / 3544
页数:4
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