SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0
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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 1

Integra SurgiMend® Collagen Matrix for Soft Tissue Reconstruction CASE STUDY Successful Management of Giant Ventral Hernia using SurgiMend 3.0 LIMIT UNCERTAINTY

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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 2

Integra® SurgiMend® Collagen Matrix for Soft Tissue Reconstruction Surgeon Profile Andrew Dennis, DO, FACOS Cook County Hospital, Chicago, IL Dr. Dennis is the Chair of the Division of Pre-Hospital and Emergency Services in the Department of Trauma and Burn at the Cook County Hospital in Chicago, IL. He is an Associate Professor of Surgery at Rush Medical College and Chairman of the Department of Surgery at Midwestern University College of Osteopathic Medicine. Successful Management of Giant Ventral Hernia using SurgiMend 3.0: A Two-Year Journey From Bridge to Re-Enforced Closure Patient...

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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 3

dressing changes and abdominal washouts. A subsequent operation included a right hemi-colectomy with primary ileocolic anastomosis for breakdown of his prior repair. During the course of the multiple returns to the operating room, it was discovered that he had developed an anastomotic leak at the ileocolic anastomosis. This was repaired primarily on two occasions, but the leak recurred. At this time, primary fascial closure of the abdominal muscles was not considered possible due to the extensive loss of domain (Figure 1A). Surgical Intervention for Abdominal Wall Closure In November 2009,...

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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 4

Integra® SurgiMend® Collagen Matrix for Soft Tissue Reconstruction The patient was seen multiple times in follow-up. His instructions upon discharge were to exercise daily and continue weight loss, as his initial weight prior to hospitalization was well over 300 lbs and his discharge weight was 240 lbs. The patient was instructed to refrain from smoking and to continue to lose weight. He was followed by the trauma nutrition service monthly, and he successfully lost 60 lbs over the next year. During his follow-up, he demonstrated only mild eventration of his bridge mesh graft. He was able to...

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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 5

was placed along with an internal plastic adhesion barrier, and the patient was taken back to the trauma intensive care unit to be resuscitated. He was placed into the Trauma Open Abdomen Protocol (OAP) which delays TAWT placement until edema is reduced and a physiologic steady state is achieved. The patient returned to the operating room three days later for washout and replacement of NPWT dressings. TAWT was again delayed as the patient’s edema was not under control. After another three days, he was again returned to the OR for washout and evaluation for TAWT. At this time the edema was...

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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 6

Integra® SurgiMend® Collagen Matrix for Soft Tissue Reconstruction Figure 6A. Following removal of the TAWT device, definitive closure was achieved. Figure 6B. Reinforced with a 10 cm by 15 cm piece of SurgiMend 3.0 placed under moderate tension as an underlay. Figure 7. The patient recovered from the last procedure without significant complications (seen here at two months). Now more than a year removed from the definitive closure, the patient has no signs of recurrence and is back to work as a laborer.

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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 7

SurgiMend Collagen Matrix for Soft Tissue Reconstruction is part of a family of soft tissue repair products Description SurgiMend is an acellular dermal tissue derived from bovine dermis. The device is supplied sterile in a variety of sizes, shapes, and thicknesses to be trimmed by the physician to meet the individual patient's needs. Indications SurgiMend is intended for implantation to reinforce soft tissue where weakness exists and for surgical repair of damaged or ruptured soft tissue membranes. SurgiMend is specifically indicated for: • Plastic and reconstructive surgery • Muscle flap...

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SurgiMend® Case Study: Successful Management of Giant Ventral Hernia Using SurgiMend® 3.0 - 8

Integra® SurgiMend® Collagen Matrix for Soft Tissue Reconstruction Availability of these products might vary from a given country or region to another, as a result of specific local regulatory approval or clearance requirements for sale in such country or region. Always refer to the appropriate instructions for use for complete clinical instructions. Non contractual document. The manufacturer reserves the right, without prior notice, to modify the products in order to improve their quality. Warning: Applicable laws restrict these products to sale by or on the order of a physician. n n n For...

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