2014 AWR / Georgetown Conference: Symposium

The Role of Biologics in Abdominal Wall Reconstruction

Part 1 Presented by:

Jesse C. Selber, MD, MPH, FACS
Associate Professor
Director of Clinical Research
Department of Plastic Surgery
Clinical Site Director, MD Anderson Cancer Network
The University of Texas MD Anderson Cancer Center

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1) Intro/Background: Rationale for Mesh in Hernia Repair

2) Comparing Synthetic and Biologic Mesh

3) When Biologic Mesh is Appropriate: VHWG Grading

4) Bridging vs. Primary Myofascial Closure

5) Perforator Sparing Techniques

6) Case Examples:

Example #1: Bridge Repair with SurgiMend and Pedicled ALT Flap
Example #2: Recurrent Hernia in the Groin with Loss of Domain Repaired with SurgiMend and a Pedicled ALT Flap
Example #3: Chronic Open Abdomen Repaired with SurgiMend and Vacuum-Assisted Closure

7) Comparing Various Biologic Meshes:

Past Experience with Alloderm in Hernia Repair
SurgiMend vs. Strattice: MD Anderson Published Clinical Data
SurgiMend vs. Strattice: Mechanical Properties Data
SurgiMend vs. Strattice and Alloderm: Long Term Superiority

8) Technique Matters: Procedural Technique Video & SurgiMend-e

Part 2 Presented by:

David M. Adelman, MD, PhD, FACS
Assistant Professor
Department of Plastic Surgery
The University of Texas MD Anderson Cancer Center

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1) Intro and Considerations: Defining Integration

2) Thoughts on Repair Techniques in AWR

General Technique Commentary
Underlay Technique
Debriding the Peritoneum for Increased Adherence
Component Separation Technique
Perforator Sparing Technique

3) Case Example #1: Large Ventral Hernia Repair

4) Case Example #2: Right Flank/Subcostal Hernia with Long Term Follow-up

5) Case Example #3: Hemipelvectomy Defect: Strength Matters

6) Case Example #4: Enterocutaneous Fistula: Contaminated Fields

7) Case Example #5: Composite Abdominal Wall Resection with SurgiMend Bridge and Soft Tissue Flap Reconstruction

8) Case Example #6: Evisceration in a Poor Healer: Open Abdomen with Vacuum-assisted Closure

9) Case Example #7: Hernia Repair in an Immunosuppressed Patient with Infectious Complications

10) Case Example #8: Hernia Repair in a Patient Undergoing Concurrent Intraperitoneal Chemotherapy and Infectious Complications

11) Conclusions & Summary