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23 February 2024 : Case report  USA

Definitive Closure Using an Ovine Reinforced Tissue Matrix in Contaminated Penetrating Abdominal Trauma

Unusual clinical course, Challenging differential diagnosis, Management of emergency care, Clinical situation which can not be reproduced for ethical reasons

Luis G. Fernandez1ABDEF*, Jason Murry1B, Marc R. Matthews2ADE, Christopher L. Thompson3CD, Mohamed Abdelgawad1F, Rebekah Bjorklund1F

DOI: 10.12659/AJCR.943188

Am J Case Rep 2024; 25:e943188

Abstract

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BACKGROUND: Cases involving penetrating abdominal trauma may be complex and often involve damage to multiple organ systems. Synthetic, biologic, and reinforced biologic matrices/reinforced tissue matrices (RBMs/RTMs) are frequently used in hernia repair and other surgical procedures requiring reinforcement, including trauma cases that require abdominal repair.

CASE REPORT: The first case was a 35-year-old male patient with a stab wound (SW) to the right side of the chest and the abdomen resulting in damage to the diaphragm, epicardium, liver, and duodenum. The second case was a 22-year-old male patient who suffered multiple traumas after an automated trencher accident, including a skull fracture with exposed brain and major lacerations to the shoulder and abdomen causing a large right-flank hernia. In both cases, OviTex® (TELA Bio, Inc., Malvern, PA), a reinforced tissue matrix (RTM), was used to help obtain and maintain abdominal wall closure. We also present an institutional economic analysis using data from the author’s institution with average case cost and future projections for procedure volume and product usage volume through 2021.

CONCLUSIONS: We report favorable outcomes in a series of patients with contaminated (CDC Wound Class III) surgical fields who underwent abdominal wall closure and reinforcement with OviTex RTM. Our work adds to the growing body of literature suggesting that reinforced biologics offer a potential alternative to biological meshes in the setting of a contaminated surgical field. Additionally, in comparison to other commonly available biologic matrices, use of OviTex RTM may be a cost-effective option to achieve abdominal wall closure even in complex cases.

Keywords: Abdominal Wall, intra-abdominal hypertension, Soft Tissue Infections, Soft Tissue Injuries, Surgical Mesh

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923