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Michal Brichacek, Kimberly Dalke, Edward Buchel, Thomas E J Hayakawa
This study evaluates a novel limited submuscular direct-to-implant technique utilizing AlloMax where only the upper few centimeters of the implant is covered by the pectoralis, whereas the majority of the implant including the middle and lower poles are covered by acellular dermal matrix. METHODS: The pectoralis muscle is released off its inferior and inferior-medial origins and allowed to retract superiorly. Two sheets of AlloMax (6 × 16 cm) are sutured together and secured to the inframammary fold, serratus fascia, and the superiorly retracted pectoralis...
July 2017: Plastic and Reconstructive Surgery. Global Open
Katharine M Hinchcliff, Hakan Orbay, Brittany K Busse, Heath Charvet, Mankushpreet Kaur, David E Sahar
AlloDerm RTU(®) and AlloMaxTM are two acellular dermal matrices (ADMs) used in implant-based breast reconstruction. In this study, we examined whether different processing methods for the ADMs lead to a disparity in histologic, clinical, and financial outcomes after breast reconstruction. Thirty patients undergoing implant-based breast reconstruction were randomized into AlloMax or AlloDerm arms (n = 15, each). ADM was placed at the time of immediate reconstruction. Patients were evaluated for complications on postoperative days 7, 14, and 30...
May 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ciara R Huntington, Tiffany C Cox, Laurel J Blair, Samuel Schell, David Randolph, Tanushree Prasad, Amy Lincourt, B Todd Heniford, Vedra A Augenstein
BACKGROUND: Biologic mesh choice in ventral hernia repair is challenging due to lack of prospective data. This study examines long-term, single-center biologic mesh outcomes. METHODS: Prospective operative outcomes data was queried for open ventral hernia repair with biologic mesh. Univariate and multivariate analysis were used to compare mesh outcomes. RESULTS: In the study, 223 patients underwent open ventral hernia repair with biologic mesh, including 40 with Alloderm, 23 AlloMax, 70 FlexHD, 68 Strattice, and 22 Xenmatrix...
December 2016: Surgery
Evan T Alicuben, Stephanie G Worrell, Steven R DeMeester
BACKGROUND: Hernia recurrence is the leading form of failure after antireflux surgery and may be secondary to unrecognized tension on the crural repair or from a foreshortened esophagus. Mesh reinforcement has proven beneficial for repair of hernias at other sites, but the use of mesh at the hiatus remains controversial. The aim of this study was to evaluate the outcomes of hiatal hernia repair with human dermal mesh reinforcement of the crural closure in combination with tension reduction techniques when necessary...
November 2014: Journal of the American College of Surgeons
Christopher A Carruthers, Christopher L Dearth, Janet E Reing, Caroline R Kramer, Darcy H Gagne, Peter M Crapo, Onelio Garcia, Amit Badhwar, Jeffrey R Scott, Stephen F Badylak
BACKGROUND: Acellular dermal matrices (ADMs) have been commonly used in expander-based breast reconstruction to provide inferolateral prosthesis coverage. Although the clinical performance of these biologic scaffold materials varies depending on a number of factors, an in-depth systematic characterization of the host response is yet to be performed. The present study evaluates the biochemical composition and structure of two ADMs, AlloDerm(®) Regenerative Tissue Matrix and AlloMax™ Surgical Graft, and provides a comprehensive spatiotemporal characterization in a porcine model of tissue expander breast reconstruction...
January 2015: Tissue Engineering. Part A
J S Roth, C Brathwaite, K Hacker, K Fisher, J King
PURPOSE: The ideal approach to complex ventral hernia repair is frequently debated. Differences in processing techniques among biologic materials may impact hernia repair outcomes. This study evaluates the outcomes of hernia repair with a terminally sterilized human acellular dermal matrix (TS-HADM) (AlloMax(®) Surgical Graft, by C. R. Bard/Davol, Inc., Warwick, RI, USA) treated with low-dose gamma irradiation. METHODS: A single-arm multi-center retrospective observational study of patients undergoing hernia repair with TS-HADM was performed...
April 2015: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Gina T Farias-Eisner, Kevin Small, Alexander Swistel, Ugur Ozerdem, Mia Talmor
UNLABELLED: Phyllodes tumors (PT) are rare fibroepithelial breast tumors representing less than 1 % of all breast malignancies. These tumors are unpredictable and fast growing with a high local recurrence rate, making this disease challenging to treat. Previous literature focused on surgical resection, and breast reconstruction following a mastectomy in patients with PT is rarely addressed. We report a case of a recurrent malignant PT treated with a nipple-sparing mastectomy followed by immediate single-stage silicone implant breast reconstruction...
April 2014: Aesthetic Plastic Surgery
John P Brosious, Nancy Wong, Gia Fowler, Linda L Stephenson, Wei Z Wang, William A Zamboni, Kayvan Taghipour-Khiabani
Acellular dermal matrix products are popular in various aspects of surgical reconstruction including hernia repairs and breast reconstructions. The goal of this study was to determine quantitative collagen weights of AlloMax (C. R. Bard, Inc. [Davol], Warwick, RI) and of contralateral dermis for composition comparison. A rehydrated sample of AlloMax was subcutaneously implanted on the dorsum of 18 male Wistar rats. Rats were randomly assigned to groups on the basis of in vivo implant time: 1, 3, and 6 weeks...
January 2014: Journal of Reconstructive Microsurgery
Matthew V Chauviere, Ryan J Schutter, Megan B Steigelman, Beth Z Clark, John Kevin Grayson, David E Sahar
BACKGROUND: Human acellular dermal matrices (HADMs) are used in a variety of settings. AlloMax is a new HADM currently being used for breast reconstruction and hernia repair. We compared the in vivo tissue integration of AlloMax to AlloDerm, a well-studied HADM, in rats. METHODS: We implanted AlloDerm and AlloMax patches into subcutaneous pockets on the backs of 32 male Sprague-Dawley rats. The animals were killed after either 4 or 8 weeks, and the patches were recovered and stained for histopathologic analyses...
September 2014: Annals of Plastic Surgery
Onelio Garcia, Jeffrey R Scott
BACKGROUND: Postmastectomy breast reconstruction remains one of the most frequently performed plastic surgery procedures in the United States. Acellular dermal matrix has been used extensively in expander-implant breast reconstruction and therefore is an appropriate material to be used to develop a clinically relevant animal model of breast reconstruction. METHODS: The study population consisted of 18 female Yorkshire pigs, which were assigned randomly to bilateral expander breast reconstruction with either AlloMax Surgical Graft or AlloDerm Regenerative Tissue Matrix (n = 9 per group)...
May 2013: Plastic and Reconstructive Surgery
Afua H Annor, Michael E Tang, Chi Lun Pui, Gregory C Ebersole, Margaret M Frisella, Brent D Matthews, Corey R Deeken
BACKGROUND: Biological scaffolds must support a complex balance of resisting enzymatic degradation while promoting tissue remodeling. Thus, the purpose of this study was to evaluate the effects of in vitro enzymatic exposure on the mechanical properties of biological scaffolds. It was hypothesized that exposure to an enzyme solution would result in decreased tensile strength and that crosslinked scaffolds would resist enzymatic degradation more effectively than noncrosslinked scaffolds...
October 2012: Surgical Endoscopy
Chi Lun Pui, Michael E Tang, Afua H Annor, Gregory C Ebersole, Margaret M Frisella, Brent D Matthews, Corey R Deeken
BACKGROUND: Coughing, bending, and lifting raise the pressure inside the abdomen, repetitively increasing stresses on the abdominal wall and the associated scaffold. The purpose of this study was to evaluate the effect of repetitive loading on biological scaffolds. It was hypothesized that exposure to repetitive loading would result in decreased tensile strength and that crosslinked scaffolds would resist these effects more effectively than non-crosslinked scaffolds. STUDY DESIGN: Nine materials were evaluated (porcine dermis: Permacol, CollaMend, Strattice, XenMatrix; human dermis: AlloMax, FlexHD; bovine pericardium: Veritas, PeriGuard; and porcine small intestine submucosa: Surgisis; in addition, Permacol, CollaMend, and PeriGuard are crosslinked)...
August 2012: Journal of the American College of Surgeons
Angela Cheng, Michel Saint-Cyr
This is a brief review of the history of the role of acellular dermal matrices in breast reconstruction surgery, with a summary of several currently available products, including a table of comparisons. Key features, including biologic tissue source, surgical preparation, sterility, polarity, contraindications, shelf life, and cost, are examined. A paucity of data exists to directly compare AlloDerm®, DermaMatrix®, Strattice™, Permacol™, DermACELL, FlexHD®, SurgiMend®, and ALLOMAX™ for breast reconstruction; most studies relate to hernia repair...
April 2012: Clinics in Plastic Surgery
Sean Orenstein, Yi Qiao, Manjot Kaur, Ulrike Klueh, Don Kreutzer, Yuri Novitsky
BACKGROUND: Inflammation and wound healing play critical roles in the integration of biologic meshes (BMs) at sites of hernia repair. Monocytes/macrophages (M/MQs) are key cells involved in mesh integration. Interleukin-1beta (IL-1beta) is one of the major M/MQ-derived cytokines, and its expression is a reflection of the degree of M/MQ activation. We hypothesized that BMs induce M/MQ activation in vitro and that IL-1beta expression by M/MQ varies among various BMs. MATERIALS AND METHODS: Acellular human dermis-derived BM samples (AlloDerm, AlloMax, FlexHD) were placed in 48-well plates and cultured with peripheral blood mononuclear cells (PBMCs) from three healthy human subjects for 7 d...
January 2010: Journal of Surgical Research
Sean B Orenstein, Yi Qiao, Manjot Kaur, Ulrike Klueh, Don L Kreutzer, Yuri W Novitsky
BACKGROUND: Inflammation and wound healing play critical roles in the integration of biologic and biodegradable meshes (BMs) at hernia repair sites. Monocytes/macrophages (M/MØs) are key cells controlling inflammation and wound healing. These cells release inflammatory cytokines and growth factors such as interleukin (IL)-1beta, IL-6, IL-8, and vascular endothelial growth factor (VEGF) upon activation. Although BMs have been increasingly used in hernia repairs worldwide, to date, investigations of inflammatory responses to various BMs have been limited...
April 2010: Surgical Endoscopy
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