We report our experience with Alloderm (acellular tissue) reconstruction for hernia defects in 10 patients. The average hernia size was 185 cm2, with mean patient age of 43 (range 22-58 yrs). Eight were recurrent hernias, one was re-recurrent, and one was a primary defect. Six were trauma laparotomies, two were renal transplant patients, and two were patients with perforated viscus with fistulae and/or ostomies. Mesh was contra-indicated in all. Fascia lata was not an available option in two patients.

Complications included one patient who developed a DVT, a wound infection, and a seroma requiring re-operation. With an average f/u of 6 months (range 12 months- 3 months), there were no recurrent hernias. This group was compared to a historical control of 78 patients with TFL graft, with a recurrence rate of 29%. They were matched for age and size of defect. The difference in outcome was statistically significant (p=0.04) via a one-sided Fisher’s Exact Test.

We report that Alloderm provides durable closure for complex hernias with no recurrence in this series of 10 patients followed for an average of 6 months. Although complications do not appear to be specific to Alloderm, a complication rate of 10% of patients is noted. Advantages of this technique include the avoidance of donor site morbidity, avoidance of prosthetics, and avoidance of wide undermining to minimize risk of seromas. Animal studies in press suggest that this tissue does become autologously replaced. Longer follow-up and larger numbers are needed to substantiate these pilot clinical findings.