Reconstruction of XXXX with autogenous pedicled demucosalized small intestinal sheet.

@entity1 @entity1320 @entity292 @entity1744
BACKGROUND: Synthetic mesh can increase the risk of complications if it is placed directly over viscera or if the site is contaminated. Therefore, the use of bioprosthetic materials has increased rapidly. Neither synthetic nor bioprosthetic mesh is ideal for reconstructing @entity1320 . Our method using an autogenous pedicled demucosalized small intestinal sheet may be an alternative. METHODS: Forty-one @entity1 with infected, complex abdominal wall defects, with a mean defect size of 108 cm(2), underwent abdominal wall reconstruction using an autogenous, pedicled, demucosalized small intestinal sheet between January 1970 and December 2006. All @entity1 had bowel and enterocutaneous fistulae in the defect. During operation, after resecting fistulae, the mucosa of the longitudinally split small intestine was scraped off with a scalpel to obtain an autogenous, pedicled, demucosalized small intestinal sheet, and then used to bridge the defect in the abdominal wall. A split thickness skin graft was then applied directly onto the demucosalized surface of the split bowel. RESULTS: The operative procedure was successful in @entity1 . The wounds between the intestinal sheets and abdominal walls healed spontaneously. Four @entity1 developed regeneration of intestinal mucosa in some of the "meshed" skin grafts at 4-5 days postoperatively. The follow-up evaluation was 24 months to 20 years. Abdominal wall herniation, @entity292 formation, or @entity1744 did not occur in these @entity1 . CONCLUSION: Autogenous, pedicled, demucosalized small intestinal sheets can be an effective method for reconstructing @entity1320 .
