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Comparing Outcomes Between Different Brands Of Biologic Mesh In Abdominal Wall Reconstruction
John Lindsey, Jr., BS, Claire Davis, MD, Carter Boyd, BS, Jack Wilson, BS, Srikanth Kurapati, MD, Timothy King, MD, Ph.D, Jorge de la Torre, MD, MSHA.
University of Alabama at Birmingham, Birmingham, AL, USA.

Purpose
The use of acellular dermal matrices is common practice in abdominal wall reconstruction (AWR) for repair of abdominal wall defects such as hernias. There are many different brands of these matrices. The purpose of this study was to investigate if there were any differences in the complication rates of two brands of acellular dermal matrices, Alloderm (LifeCell) and Cortiva (RTI).
Methods
A retrospective analysis of AWR using two acellular dermal matrices. These reconstructions were performed by a single surgeon at the University of Alabama from January 2017 to August 2018. Patients were analyzed through chart review to determine hernia location and size, prosthetic matrix used, and complications. Fisher exact test was used to compare complication rates between matrices. Inclusion criteria was the usage of the reconstructive mesh materials Alloderm or Cortiva in abdominal wall reconstruction surgery.
Results
A total of 44 patients were reviewed, 18 of which were treated with Cortiva mesh and 26 of which were treated with Alloderm. Complications rates were 50.0% and 50.0% for Cortiva and Alloderm, respectively (p=1.000). Average drain duration, was 28.5 days for Cortiva and 27.3 days for Alloderm (p=0.8114). seroma and wound infection were the most common complications occurring in 7 and 6 patients, respectively. Additional complications included hematoma, wound dehiscence, flap necrosis, and hernia recurrence.
Conclusions
The complication rates in abdominal wall reconstruction when using Alloderm versus Cortiva grafts were not significantly variable. According to these statistics, neither brand was superior amongst the patients and data points of this retrospective analysis.
Table 1. Patient Complications within two months of surgery by matrix using Fisher's exact test.

VariableTotal (%)AlloDerm (%)Cortiva (%)P-value
Overall Complication22 (50.0)13 (50.0)9 (50.0)1.000
Seroma7 (15.9)6 (23.1)1 (5.6)0.211
Hematoma2 (4.5)1 (3.8)1 (5.6)1.000
Wound infection6 (13.6)2 (7.7)4 (22.2)0.208
Wound dehiscence9 (20.5)5 (19.2)4 (22.2)1.000
Flap necrosis1 (2.3)0 (0.0)1 (5.6)0.409
Complication leading to reoperation5 (11.4)3 (11.5)2 (11.1)1.000
Hernia Recurrence1 (2.3)1 (3.8)0 (0.0)1.000

Table 2. Patient demographics and comorbidities.
Population Demographics
Number (Percentage)p-value
Age (years)
Alloderm
Cortiva
56.8
55.2
0.673
Sex
Alloderm
Cortiva
M = 7 (26.9), F = 19 (73.1)
M = 5 (27.8), F = 13 (72.2)
1.000
Morbid Obesity
Alloderm
Cortiva
9 (34.6)
7 (38.9)
1.000
Current Smoker
Alloderm
Cortiva
2 (7.7)
2 (11.1)
1.000
Former Smoker
Alloderm
Cortiva
7 (26.9)
7 (38.9)
0.515
Diabetes
Alloderm
Cortiva
6 (23.1)
4 (22.2)
1.000
Hypertension
Alloderm
Cortiva
9 (34.6)
12 (66.7)
0.065
Immunosuppression
Alloderm
Cortiva
1 (3.8)
1 (5.6)
1.000
Hx of DVT
Alloderm
Cortiva
1 (3.8)
1 (5.6)
1.000


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