Bridging Acellular Dermal Matrix in Abdominal Wall Repair following Radical Resection of Recurrent Endometrioma
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Summary: The patient is a 31-year-old woman with a history of prior resection of a presumed keloid scar around her Pfannenstiel incision found to be endometrial tissue on final pathology. She presented 5 years later with recurrence of pain and a mass associated with menses despite maximal medical therapy for endometriosis. Computed tomography of her abdomen and pelvis demonstrated an infiltrative soft tissue mass measuring 8.8 cm × 4.0 cm. Surgical oncology conducted an en bloc resection of the mass and obstetrics and gynecology performed a concomitant total abdominal hysterectomy and bilateral salpingo-oophorectomy. Plastic and reconstructive surgery completed the repair of the final 23 cm × 10 cm full-thickness abdominal wall defect with bridging biologic mesh, complex layered closure, and incisional negative-pressure wound therapy. Final pathology confirmed a diagnosis of endometriosis. Patient’s hospital course was uncomplicated, and follow-up at 6 months does not demonstrate clinical or radiographic evidence of bulge or hernia recurrence. Abdominal wall endometrioma is a well-documented occurrence in prior cesarean scars; plastic surgeons can contribute to a multidisciplinary approach in reconstruction when resection compromises abdominal wall integrity, necessitating expertise in complex repairs.
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Our report, in which the patient progressed without postoperative complications or recurrence, supports several previous reports that claim that appropriate resection of CSE and reconstruction with artificial mesh is useful.
“Our report, in which the patient progressed without postoperative complications or recurrence, supports several previous reports that claim that appropriate resection of CSE and reconstruction with artificial mesh is useful [1, 6, 7].”
From Resection and Abdominal Wall Reconstruction for Cesarean Scar Endometriosis (2022) · cites this paper as [6]
Only a few reports describe the use of reconstructive techniques such as abdominal wall plasty and the flap technique, to prevent recurrence and herniation.
“only a few reports describe the use of reconstructive techniques such as abdominal wall plasty and the flap technique, to prevent recurrence and herniation [4–6].”
From Resection and Abdominal Wall Reconstruction for Cesarean Scar Endometriosis (2022) · cites this paper as [6]
Hormonal treatments such as gonadotropin-releasing hormone agonists, danazol, and progesterone have been used and provide only temporary relief, and symptoms often recur with discontinuation.
“Hormonal treatments such as gonadotropin-releasing hormone agonists, danazol, and progesterone have been used and provide only temporary relief, and symptoms often recur with discontinuation [6].”
From Resection and Abdominal Wall Reconstruction for Cesarean Scar Endometriosis (2022) · cites this paper as [6]
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Cites
Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases
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Modern reconstructive techniques for abdominal wall defects after oncologic resection
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Self-citationComplex Abdominal Wall Repair Using a Porcine Dermal Matrix
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A Comparison of Acellular Dermal Matrices in Abdominal Wall Reconstruction
Maxwell, D. W., Hart, A. M., Keifer, O. P., Halani, S. H., & D, A. L. M. (2018) · Annals of Plastic Surgery · doi:10.1097/sap.0000000000001692 · Cited by 20 · see citing works
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Acellular dermal matrix in reconstructive surgery: Applications, benefits, and cost
Mohammadyari, F., Parvin, S., Khorvash, M., Amini, A., Behzadi, A., HajEbrahimi, R., Kasaei, F., & Olangian‐Tehrani, S. (2023) · Frontiers in Transplantation · doi:10.3389/frtra.2023.1133806 · Cited by 49 · see citing works
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Allen, S. E., Rindos, N. B., & Mansuria, S. (2021) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000714 · Cited by 31 · see citing works
Resection and Abdominal Wall Reconstruction for Cesarean Scar Endometriosis
Takaya, K., Shido, H., & Yamazaki, S. (2022) · Case Reports in Medicine · doi:10.1155/2022/7330013 · Cited by 3 · see citing works
“Hormonal treatments such as gonadotropin-releasing hormone agonists, danazol, and progesterone have been used and provide only temporary relief, and symptoms often recur with discontinuation [6].”
BackgroundResultAn obstetrician-gynecologist’s review of hernias: risk factors, diagnosis, prevention, and repair
Knochenhauer, H. E., Lim, S. L., Brown, D. A., Darner, G. R., Levinson, H., Havrilesky, L. J., & Previs, R. A. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2023.04.024 · Cited by 3 · see citing works
Harrah, P. C., Deering, A. J., Chung, M. T., Hughes, K., & Hosein, R. C. (2024) · Plastic and Reconstructive Surgery, Global Open · doi:10.1097/gox.0000000000005904
“17 Although, beyond the scope of this review, it is worth mentioning that the mesh may be composed of various synthetic or biological materials, selection of which would depend on the needs of the case.”
BackgroundThe spectrum of abdominal wall desmoid fibromatosis and the outcomes of its surgical treatment
Bombil, I., & Ngobese, L. (2021) · South African Journal of Surgery · doi:10.17159/2078-5151/2021/v59n3a3355
Chen, Y., Wu, L., Qian, C., Wu, W., Chu, B., & Dong, J. (2024) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15913
- Authors
- Hackenberger, P. N., Poteet, S. J., & Janis, J. E.
- Affiliations
- The Ohio State University (US)
- The Ohio State University Wexner Medical Center (US)
- Corresponding author
- Hackenberger, Paige N.
- Venue
- Plastic and Reconstructive Surgery - Global Open
- Published
- 2020-01
- Volume
- 8
- Issue
- 1
- Pages
- e2603
- ISSN
- 2169-7574 (ISSN-L)
- PMC
- PMC7015587
- OpenAlex
- W3001329143
- Cited by
- 7
- References
- 11
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 1 · 2021: 2
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Plastic & Reconstructive Surgery Global Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Surgery › Congenital Anomalies and Fetal Surgery
- Keywords
- endometrioma, abdominal wall reconstruction, acellular dermal matrix, abdominal wall defect, recurrent endometriosis, cesarean section scar, Pfannenstiel incision, radical resection, total abdominal hysterectomy, bilateral salpingo-oophorectomy, negative pressure wound therapy, layered closure, hernia recurrence
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