The Use of Autologous Fenestrated Cutis Grafts in Hernia Repair

• Published in: The American surgeon 2020-07, Vol.86 (7), p.819-825
• Main Authors: Hodgdon, Ian, Cook, Michael, Yoo, Aran, Rajo, Marco, Dooley, Danielle, Haydel, Adam, Dogar, Shireen, Greiffenstein, Patrick, Morrison, John, Lau, Frank, Paige, John
• Format: Article
• Language: English
• Subjects: Abdomen; Autografts; Body mass; Body mass index; Body size; Breast; Cardiovascular disease; Case reports; Coronary artery; Coronary artery disease; Cysts; Demographics; Demography; Diabetes; Diabetes mellitus; Fistula; Grafting; Grafts; Heart diseases; Hernia; Hernias; HIV; Human immunodeficiency virus; Hypertension; Infections; Laparoscopy; Pain; Patients; Plastic surgery; Skin; Skin & tissue grafts; Squamous cell carcinoma; Surgery; Surgical mesh; Teaching hospitals; Tobacco; Viruses
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/0003134820933261

Autologous HR is not a new concept. Since Loewe first proposed the use of dermal grafts for HR, 7 this method has been widely explored by a variety of authors. Overall, the risk of squamous cell carcinomas associated with epidermoid cysts is low: 0.011%-0.045%, and the association between cutis grafts and carcinoma has not been proven. 13 Other case reports document carcinoma associated with other methods such as synthetic mesh repairs. 14 Notably, dermal grafts or dermal-fat grafts are currently widely used for a variety of reconstructive procedures such as breast reduction, deep inferior epigastric perforator flaps, cleft palat repair in children, and facial reconstruction. 15 Contemporary international reports have demonstrated the safe use of CA in HR. Patients treated with synthetic mesh more frequently reported pain at the surgical site at 3 months post-op compared with the CA group. 9 This same group has presented a follow-up paper at 1 year showing no statistical difference between the 2 groups. 16 We performed a multisurgeon, multi-institutional retrospective study of the use of CA for open and laparoscopic HRs in 97 consecutive patients over a short-term follow-up period to determine its overall efficacy as a HR modality. Table 1 Demographics of Patients Undergoing Hernia Repair. n % Total patients/total hernias 97/99 Average age, years 67.18 Average body mass index 33.09 Male 51 52 History of prior hernias 34 36 Prior abdominal surgeries 59 65 Current tobacco use 18 19 History of tobacco use 33 35 Diabetes mellitus 16 17 Hypertension 50 53 Coronary artery disease 7 7 Human immunodeficiency virus 6 6 Operative Details Operative characteristics are summarized in Table 2.