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susceptible to opportunistic also at increased risk for infection from common pathogens. organisms, but they are
Immunosuppressed
Surgical Intervention
AL LODERM
The inferior most aspect of the midline fascial defect was closed primarily without tension using interrupted polypropylene sutures. The skin was closed over the AlloDerm with a running suture. The entire wound was covered with a clean, dry dressing. The patient was placed in an abdominal binder and was ambulating without any difficulties on postoperative day 1. The results of the pancreas biopsy were negative for acute rejection. In fact, the hyperglycemia was caused by type II diabetes related to the patient's weight gain since the SPK. A serum C-peptide confirmed this diagnosis. He was started on an oral diabetes agent with good results. The wound was examined on post-operative day 3 and appeared to be healing well without any signs of dehiscence. He was discharged home on post-operative day 3. At 6 months follow-up, the patient was doing well with no recurrence of the hernia and no other complications. The diabetes is under control with an oral agent.
AlloDerm was chosen for its significant benefits...especially in this immunospressed transplant patient. Conclusion
For many individuals with an intact immune response, an incisional hernia may be repaired using one of several options available to the surgeon. However, the options are limited in immunosuppressed patients. For example, if a synthetic mesh is seeded with bacteria and becomes infected, it must be removed as the offending organisms are extremely difficult, if not impossible to clear with antibiotics. Also, the secondary interventions needed to deal with seromas common after the hernia repair increase the possibility of mesh infection and the need for re-operation. Figure 2. Using an underlay technique, one sheet Under these circumstances, a biological material such as of AlloDerm (4 x 12 cm) was placed in the midline AlloDerm may be preferred over a synthetic, since it may defect. be less vulnerable to infection and is even a viable option in clean-contaminated cases. Therefore, AlloDerm was chosen for its significant benefits, including its ability to support rapid revascularization for infection resistance, integration into native tissue, and resistance to adhesion formation, especially in this immunosuppressed transplant patient.
Many variables including patient pathology, anatomy, and surgical techniques may influence procedural outcomes. Before use, physicians should review all risk information, which can be found in the Directions for Use attached to the packaging of each AlloDerm graft. LifeCell Corporation
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