Gingival augmentation surgery with soft tissue autografts long has been the standard for increasing the width of keratinized oral tissue. Acellular dermal allografts, which have been used for several years by reconstructive surgeons, are a novel technique for achieving increased gingival tissue in place of soft tissue autografts. This ...

Grafting with autogenous tissue or freeze-dried skin is the generally accepted method for increasing and/or restoring the width of attached gingiva. This article describes the periodontal use of an acellular dermal allograft previously available for treating burn patients. When used as a gingival graft, this new ...

Background:Type III paraesophageal hernias are diaphragmatic defects with the risk of serious complications. High recurrence rates associated with primary suture repair are significantly improved with the use of a tension-free repair with prosthetic mesh. However, mesh in the hiatus is associated with multiple complications. A bioengineered material from donated human tissue offers an attractive ...

Treatment of plantar fat pad migration and atrophy has caused concern for decades. Patients can present with pain, callus formation, or ulceration. The purpose of this article is to review the results of a consecutive series of patients treated for fat pad atrophy of the plantar foot, using a minimally invasive implantation of an acellular human dermal ...

Alveolar ridge deformities are usually the result of trauma, periodontal disease, surgical insult, or developmental defects. Preventing ridge collapse with the extraction of maxillary anterior teeth is vital to an esthetic restorative result. Several techniques are available to prevent ridge collapse. In these case presentations, ridge preservation was achieved utilizing an ...

Various vestibular extension procedures have been described in the literature over the past 6 decades, including the use of free gingival grafts. An acellular dermal allograft has been used as a substitute for autogenous soft tissue grafts in root coverage procedures. This clinical report describes the use of such an ...

A 23-year-old female with Ewing's Sarcoma underwent tibial resection and skeletal reconstruction using proximal tibial allograft prosthetic reconstruction with distal femur endoprosthetic reconstruction and rotating hinge. Human acellular dermal matrix, (Alloderm, LifeCell, Branchburg, NJ, USA), was used to wrap the skeletal ...

A 23-year-old female with Ewing's Sarcoma underwent tibial resection and skeletal reconstruction using proximal tibial allograft prosthetic reconstruction with distal femur endoprosthetic reconstruction and rotating hinge. Human acellular dermal matrix, (Alloderm, LifeCell, Branchburg, NJ, USA), was used to wrap the skeletal ...

Obliteration of the sphenoid sinus using fat is often used after transsphenoidal hypophysectomy. The morbidity of this approach includes donor site complications, fat necrosis, and delayed mucocele formation. As obliteration with fat is intended to prevent cerebrospinal fluid (CSF) leakage, an alternative for this technique would be techniques used for CSF rhinorrhea repair. Instead of sinus ...

The aim of this presentation was to discuss the effectiveness of the acellular dermal matrix in root coverage therapy and in alveolar ridge augmentation, based on three controlled randomized clinical trials conducted by our research team (Novaes Jr et al., 2001; Barros et al., 2005; Luczyszyn et al., 2005). The first and second studies highlight the ...

This article describes a technique in which an acellular dermal allograft is used in combination with a photopolymerized acrylic resin stent to increase the zone of keratinized tissue around osseointegrated dental implants. During the second-stage surgery, a split thickness labial flap is reflected and apically repositioned by being ...

The aim of this study was to investigate the effect of beta-tricalcium phosphate (?-TCP) particles in combination with acellular dermal matrix (ADM) allograft in gingival recession. Experimental gingival recession defects were created in beagle dogs and randomly assigned to one of the following groups: ADM, ADM + ?-TCP, or coronally ...

Multiple techniques have been employed for the repair of abdominal incisional hernias with varying rates of success. Primary fascial apposition and prosthetic implantation have been associated with high rates of secondary recurrence, infection, and other complications, often due to insufficient alleviation of tension and implant intolerance. This study evaluates the repair of incisional and ...

Different techniques have been proposed for the treatment of gingival recession. This study compared the clinical results of gingival recession treatment using a subepithelial connective tissue graft and an acellular dermal matrix allograft. Seven patients with bilateral Miller class I or II gingival recession were selected. Twenty-six ...

Ligament reconstruction tendon interposition arthroplasty is currently the preferred technique for carpometacarpal joint arthritis of the thumb by most surgeons. Despite its efficacy, morbidity has been associated with the harvest of the flexor carpi radialis tendon. Using an allograft as material for arthroplasty, donor site morbidity is avoided. In this report, we present ...

When maxillary anterior teeth are extracted, subsequent ridge collapse can significantly compromise esthetics. Preservation of an adequate volume of bone is vital to successful implant placement. Ridge preservation achieved utilizing an acellular dermal matrix as a barrier membrane with a demineralized freeze-dried bone allograft has ...

Glycerin Cryopreserved Acellular Corneal Tissue; Deep Anterior Lamellar Keratoplasty; High Risk Keratoplasty

Treatment of gingival recession has been a common practice in periodontics for years. As esthetic demands of periodontal patients increase, more root coverage procedures will be performed to satisfy esthetic demands. Often patients present with multiple areas requiring treatment. Palatal anatomy may limit the amount of autogenous tissue that can be harvested, limiting the number of procedures that ...

We report long-term follow-up results of acellular dermal matrix (ADM) allograft combined with thin split-thickness skin autograft (STSG) for burn treatment. Between March 2001 and May 2007, we treated 19 cases of burn wounds or scar wounds at 34 different body sites with ADM allograft combined with STSG. All ...

During the surgical treatment of burns and reconstructive surgery, we can use autografts, allografts, xenografts or dermal substitutes. Acellular dermal substitutes, implantable medical devices of class III are composed mostly of collagen but also, more recently, derivatives of hyaluronic acid (Hyalomatrix ...

Prevention and treatment of capsular contracture after breast augmentation is a controversial and oftentimes vexing problem. While there are traditional methods of addressing this condition, acellular dermal matrix materials offer a new and promising modality that is gaining momentum in the field of plastic surgery. In this article, the author examines the ...

Introduction: Processed nerve allografts offer a promising alternative to nerve autografts in the surgical management of peripheral nerve injuries where short deficits exist. Methods: Three established models of acellular nerve allograft (cold-preserved, detergent-processed, and AxoGen-processed nerve allografts) ...

Acellular dermal matrix grafts have become a good alternative to autogenous soft tissue grafts in root coverage. Until now, the literature has reported short- or medium-term data regarding the stability of the gingival margin after the use of acellular dermal matrix on root coverage. The aim of this article is to ...

Soft tissue augmentation has become increasingly important as more individuals seek aesthetic improvement without major surgical procedures. The choice of an appropriate subcutaneous implant, whether solid or injectable, requires a thorough understanding of the materials available. This review of the literature addresses autologous fat and dermis transplantation, autologous and allogeneic human ...

The proper management of gingival recession is critical to the establishment of a natural-appearing soft tissue architecture. Subepithelial connective tissue grafts have been considered the "gold standard" but are limited by the availability of palatal donor tissue. Tunnel techniques have improved the esthetic results of connective tissue grafting. Acellular ...

This study enrolled 22 participants with hypertrophic scarring after burn who received treatment with co-transplantation of acellular dermal matrix and epidermis of either normal skin or scar tissue. Scar thickness was evaluated with high frequency ultrasonography and the distribution of keratinocyte stem cells was detected by immunostaining. The results ...

Pelvic floor reconstruction after pelvic exenteration is challenging, particularly with bacterial contamination and/or pelvic irradiation. Traditional regional myocutaneous flap options are not always avaliable, especially in the multiply operated patient. Human acellular dermal matrix (HADM) confers several advantages and is associated with less morbidity ...

The primary goal of palatoplasty is to allow normal speech through the correction of velopharyngeal incompetence. Failure to accomplish a tension-free, watertight closure predisposes the palatoplasty patient to postoperative fistula formation. Fistulas may in turn contribute to velopharyngeal incompetence. Reported fistula rates vary widely, ranging from 0% to greater than 70%; recurrence rates ...

Finger degloving injury remains one of the most difficult challenges in hand reconstructive surgery. We report the use of an acellular dermal regeneration template to create a neodermis, followed by a secondary, full-thickness skin graft on a complete finger degloving injury, achieving a satisfactory recovery of range of motion and a cosmetically ...

Symptomatic forearm hernias are troublesome conditions infrequently presented in the literature. We describe a novel approach using cadaveric acellular dermal matrix in an inlay technique to restore fascia integrity. In 2 patients who perform heavy labor, this technique resolved their hernia-related symptoms and allowed them to resume work activities. ...

Perineal hernia is an infrequent complication of abdominoperineal resection, but can be problematic. Multiple surgical approaches to the repair of perineal hernia have been described, including abdominal, perineal, and combined methods; most feature the use of a prosthetic mesh. We report a case wherein a large perineal hernia was reduced via an abdominal approach, and then repaired by the ...

Diaphragmatic hernias occur in up to 2% of patients after esophagectomy with gastric pull-up, and the surgical repair in the setting of a previous esophagectomy is a challenge with high complication rates, in particular with regards to the gastric conduit and its critical vascular supply. We describe two cases and the technique of minimally invasive, laparoscopic repair of diaphragmatic defects ...

A ventral hernia and a contaminated surgical field are a difficult surgical combination. We hypothesize that acellular human dermis (AHD) can be a suitable biological tissue alternative in the repair of a ventral hernia. The study involved a retrospective review of the use of AHD in the repair of ventral hernia from 2001-2004. Inclusion criteria included a ventral hernia ...

... has gained popularity over chemical methods for sterilizing human tissues and medical devices accessible due to the safety ... irradiation has been a major concern for implantable human tissues and biomed...

An alternative treatment for low rectal cancer is the extended posterior perineal approach with reconstruction of the pelvic floor (cylindrical technique). Pelvic floor defects often require flap reconstruction using gracilis flaps, vertical rectus abdominis myocutaneous flaps or local fasciocutaneous flap. In this article, the complicated pelvic floor defect was reconstructed with human ...

The use of acellular dermal matrix (ADM) in many plastic surgery procedures, including breast reconstruction, has increased dramatically in recent years. While expander/implant reconstruction can be performed successfully with standard techniques, the introduction of ADM has added a new tool with which to achieve lasting, predictable results. This article ...

Breast augmentation is one of the most commonly-performed cosmetic procedures worldwide. Unfortunately, many women require revisionary surgery related to unsatisfactory results or complications such as capsular contracture, implant malposition, and ptosis. While, historically, surgeons have relied on often-imperfect native tissue to correct these deformities, acellular ...

Abdominal wall reconstruction is a complex and challenging surgical undertaking. While permanent prosthetic mesh is considered the gold standard for minimizing hernia recurrence, placement of synthetic mesh is sometimes imprudent due to contamination or risk of infection. Acellular dermal matrices (ADM) offer an exciting biologic alternative. This article ...

Acellular dermal matrix (ADM) use in prosthetic breast reconstruction has become increasingly popular. Several benefits have been reported with this technique including diminished donor-site morbidity and improved aesthetic outcomes. Recently, in an effort to ascertain the overall safety and efficacy of this approach, an emphasis has been placed on ...

Full-thickness burn and other types of deep skin loss will result in scar formation. For at least partial replacement of the lost dermal layer, there are several options to use biotechnologically derived extracellular matrix components or tissue scaffolds of cadaver skin origin. In a survey, we have collected data on 18 pts who have previously received ...

The objective of this study was to develop a palatal mucosa equivalent composed of multilayered oral keratinocytes grown on the acellular porcine dermal matrix. Acellular porcine dermal matrix was prepared through a series of procedures and assessed by histological, immunohistochemical, and scanning electron ...

Many techniques are available to repair tendon ruptures of the Achilles tendon as well as other foot and ankle tendons. The purpose of this article was to present a technique of tendon repair that is a combination of a tendon graft inlay with a Pulvertaft-type tendon weave using an acellular human dermal matrix graft with a resultant "strip and shoelace." ...

Background: Dermal skin substitutes have become a standard of care in burn treatment. Objective: To compare and assess wound contracture reduction and histologic incorporation into the wound, dermal substitutes were implanted into full-thickness skin wounds in nude mice. Materials and Methods: Thirty-seven mice received a full-thickness 2 � 2 cm dorsal ...

In this study, we aimed to evaluate the potential of tissue-engineered nerve grafts created from acellular allogenic nerve tissues combined with autologous bone marrow stromal cells (BMSCs) for repairing large peripheral nerve lesions. In a rhesus monkey model, a 2.5-cm-long gap was created in the radial nerve, followed by implantation of either autografts or ...

When not enough conventional autologous nerve grafts are available, alternatives are needed to bridge nerve defects. Our aim was to study regeneration of nerves in chemically-extracted acellular nerve grafts from frogs, mice, humans (fresh and stored sural nerve), pigs and rats when defects in rat sciatic nerves were bridged. Secondly, we compared two different extraction ...

Frontonasal dysplasia is a severe malformation composed of cranial, ophthalmic, nasal, upper lip, and palatal deformities. Reconstruction in these patients requires complex craniofacial efforts. A 19-year-old woman with frontonasal dysplasia was treated at our institution where she had undergone multiple prior reconstructive surgeries including facial bipartition and cantilevered calvarial bone ...

Full-thickness scalp defects with exposed calvarium pose a reconstructive challenge, particularly in patients with extensive comorbidities. A single-stage acellular dermal matrix and split-thickness skin graft reconstruction represents a simple and valuable surgical approach to achieving durable scalp coverage without requiring a donor-site or prolonged ...

Full-thickness scalp defects with exposed calvarium pose a reconstructive challenge, particularly in patients with extensive comorbidities. A single-stage acellular dermal matrix and split-thickness skin graft reconstruction represents a simple and valuable surgical approach to achieving durable scalp coverage without requiring a donor-site or prolonged ...

AIM: To investigate the efficacy of acellular dermal matrix (ADM) for intestinal elongation in animal models.METHODS: Japanese white big-ear rabbits (n = 9) and Wuzhishan miniature pigs (n = 5) were used in the study. Home-made and commercial ADM materials were used as grafts, respectively. A 3-cm long graft was interposed in continuity with the small ...

Biologic prostheses have emerged to address the limitations of synthetic materials for ventral hernia repairs; however, they lack experimental comparative data. Fifteen swine were randomly assigned to 1 of 3 bioprosthetic groups (DermaMatrix, AlloDerm, and Permacol) after creation of a full thickness ventral fascial defect. At 15 weeks, host incorporation, hernia recurrence, adhesion formation, ...

Desmoid tumour resection is a known, albeit rare, cause for chest wall reconstruction. Traditionally, musculocutaneous flaps and synthetic mesh materials have been employed for coverage over these potentially large thoracic defects. More recently, biologic mesh materials have become increasingly more prevalent in a multitude of surgical reconstructions. To date, the current literature describes ...

The digital fibroosseous pulley system is essential for optimum function of the flexor tendons and the continuation of normal hand functions. Different materials have been used for pulley reconstruction in the literature but the ideal material is still controversial. In this study, after the excision of the A2 pulley, pulley reconstructions were performed by using acellular ...

Anastomotic stricture after rectal resection is an intractable complication of rectal sugery. We present a case to introduce a new method to deal with rectal defect after dissecting anastomotic stricture by using biomaterial. The patient was diagnosed with rectal anastomotic stricture after radical resection for rectal carcinoma and was treated by reoperation. There was a defect in the posterior ...

Rhinoplasty often relies on graft material for structural support in the form of cartilage, bone grafts, or fascia. In addition, pliable grafts are often helpful for contouring and can function as a barrier. Unfortunately, grafts carry the disadvantage of requiring an additional donor site, with associated complications. Human acellular dermal matrix (ADM) ...

Acellular dermal matrix (ADM) is a recently-developed, biologically-derived product with many useful applications in plastic surgery, in both cosmetic and reconstructive procedures. While the use of ADM initially outpaced quality literature, within the past 10 years the literature on ADM has rapidly expanded. Some of these data show promising results in ...

Although the principles of burn management are still primarily focused on survival, as advances are realized in resuscitation, nutrition, and wound management, the functional and aesthetic outcomes following burn injury have become increasingly important. Acellular dermal matrix materials, which allow surgeons to minimize skin graft donor site morbidity in ...

Acellular dermal matrices (ADM) are becoming an integral component of immediate implant-based breast reconstruction, providing inferolateral coverage and support of the implant. Currently, five ADM products are available on the market for this purpose. Although their application has resulted in improved aesthetic results with low complication rates, the ...

Acellular dermal matrices (ADM) have generated interest for their possible applications in secondary revisions following prosthetic breast reconstruction. These materials can be effective in a variety of situations, including implant displacement, synmastia, capsular contracture, incisional support, and pocket conversion. ADM can also be placed in the ...

ObjectiveTo examine porcine acellular dermal matrix (ADM) as a xenogenic dermal substitute in a rat model. Summary Background DataAcellular dermal matrix has been used in the treatment of full-thickness skin injuries as an allogenic dermal substitute providing a stable ...

Previously, we have described the development of an acellular porcine meniscal scaffold. The aims of this study were to determine the immunocompatibility of the scaffold and capacity for cellular attachment and infiltration to gain insight into its potential for meniscal repair and replacement. Porcine menisci were decellularized by exposing the tissue to freeze-thaw cycles, ...

Previously, we have described the development of an acellular porcine meniscal scaffold. The aims of this study were to determine the immunocompatibility of the scaffold and capacity for cellular attachment and infiltration to gain insight into its potential for meniscal repair and replacement. Porcine menisci were decellularized by exposing the tissue to freeze�thaw cycles, ...

In search of an optimal transplantation regime for sufficient dermal and epidermal regeneration after a full-thickness skin injury, wounds on athymic rats were grafted with split-thickness skin grafts or acellular human dermis followed by transplantation with human keratinocytes either in single-cell suspension or cultured on porous biodegradable ...

The purpose of this study was to validate supercritical carbon dioxide (SC-CO(2)) as a terminal sterilization method for biological materials, specifically acellular dermal matrix. In this study, bacterial spores, Bacillus atrophaeus, were inoculated onto porcine acellular dermal matrix to serve as a "worst case" ...

Lateral canthal dystopia can lead to lower eyelid malposition, abnormal lateral eyelid fissure appearance, and lagophthalmos. In most cases, the lateral canthus can be repaired with a standard lateral canthopexy or canthoplasty. In a fraction of cases, especially when recurrent, the surgical repair may require additional lateral canthal reinforcement. PMID:21629140

Soft tissue replacement using a filler as a temporary scaffold to encourage revascularization and tissue in growth is an exciting concept. Sheets of acellular human dermal matrix, called Alloderm (Lifecell Corp, Branchburg, NJ), have been shown to do just that. When implanted into a patient, tissue growth and revascularization have both been observed. The ...

In 2008, the authors published data from a series of 69 patients (129 eyelids) who had been treated with EnduraGen during eyelid surgery. They have since gained experience with this material in an additional series of 19 patients, in whom the results have continued to be promising. In this article, the authors discuss some of the subtleties inherent in this procedure and present their surgical ...

Structural allografts used for critical bone defects have limited osteogenic properties for biointegration. Although ex vivo tissue-engineered constructs expressing bone morphogenetic protein-2 (BMP2) have demonstrated efficacy in critical defect models, similar success has not been achieved with off-the-shelf acellular approaches, including ...

Olfactory groove meningiomas represent 10% of intracranial meningiomas and arise in the midline of the anterior cranial fossa along the dura of the cribriform plate and planum sphenoidale. Hyperostosis of the adjacent underlying bone is common, and further extension into ethmoid sinuses and nasal cavity can occur in 15%-25% of cases. Radical tumor resection including the involved dural attachment ...

In the pursuit of a transplantable construct for the replacement of large skeletal muscle defects arising from traumatic or pathological conditions, several attempts have been made to obtain a highly oriented, vascularized and functional skeletal muscle. Acellular scaffolds derived from organ decellularization are promising, widely used biomaterials for tissue engineering. ...

A study was conducted to try to improve upon existing conservative techniques in the treatment of chronic pilonidal sinus by using human dermal tissue allograft. A prospective study of 46 consecutive patients undergoing 47 operations for pilonidal disease was conducted by three surgeons. All patients underwent a conservative surgical technique with ...

Little is known about the long-term properties of fresh cold-stored osteochondral allograft tissue. We hypothesized fresh cold-stored tissue would yield superior material properties in an in vivo ovine model compared to those using freeze-thawed acellular grafts. In addition, we speculated that a long storage time would yield less successful grafts. We ...

The ability to engineer whole organs as replacements for allografts and xenografts is an ongoing pursuit in regenerative medicine. While challenges remain, including systemic tissue integration with angiogenesis, lymphatiogenesis and neurogenesis, ongoing efforts are working to develop novel technologies to produce implantable engineered scaffolds and potentially engineered ...

This article describes the use of an acellular human dermal regenerative tissue matrix as an interpositional spacer to maintain the distance between the cuboid and navicular, and to prevent recurrence, following surgical excision of a cuboid-navicular tarsal coalition in an adult female. The use of this acellular matrix as an ...

PURPOSE: To determine whether deep anterior lamellar keratoplasty (DALK) using acellular glycerol-cryopreserved corneal tissue (GCCT) could prevent allograft rejection in high-risk corneas. DESIGN: Prospective, randomized, comparative study. METHODS: Settings: The Eye Hospital, Wenzhou Medical College, Zhejiang, China. Study population: All patients with ...

BACKGROUND: Non-cross-linked xenogeneic extracellular matrix graft materials have typically elicited a hypersensitivity reaction when implanted into humans or other primates. The purpose of this study was to examine the histologic and immune response to a non-cross-linked porcine-derived dermal extracellular matrix graft processed to remove the ?-gal epitope. MATERIALS AND ...

Objective: Acellular human tendons are a candidate scaffold for tissue engineering flexor tendons of the hand. This study compared acellularization methods and their compatibility with allogeneic human cells. Method: Human flexor tendons were pretreated with 0.1% ethylenediaminetetracetic acid (EDTA) for 4?h followed by 24?h treatments of 1% Triton X-100, ...

Objective: Acellular human tendons are a candidate scaffold for tissue engineering flexor tendons of the hand. This study compared acellularization methods and their compatibility with allogeneic human cells. Method: Human flexor tendons were pre-treated with 0.1% ethylenediaminetetracetic acid (EDTA) for four hours followed by twenty four hour treatments ...

AIM: To present our trial using a combination of the human acellular dermal matrix (HADM) implant and an interpositional omentum flap to repair giant abdominal wall defects after extensive tumor resection.METHODS: Between February and October of 2007, three patients with giant defects of the abdominal wall after extensive tumor resection underwent ...

This study aimed to clarify the phenotypical differentiation of recruited macrophages following subdermal implantation of an allogenous, acellular dermal matrix (aADM). In 20 male Wistar rats, one leg was randomly chosen for subcutaneous implantation of an aADM, while the other side received an autogenous dermis graft for control purposes. After 7 and 14 ...

A comparative cost analysis of breast reconstruction using acellular dermal matrix (ADM) and traditional tissue expander-/implant-based techniques was carried out. Medicare reimbursement costs were calculated for tissue expander/implant alone (TE/I), TE/I with ADM (TE/I + ADM), and single-stage implant (SSI) with ADM (SSI + ADM). The most expensive ...

Breast implant malposition is an increasingly recognized complication of breast augmentation and implant-based breast reconstruction. Etiologic factors include technical imprecision during surgery with overdissection or inadequate dissection of the pocket, inappropriately large implant selection, and the compromise of the local breast tissues, which produces an inability of a patient's natural ...

Several porcine-derived acellular biologic grafts are increasingly used in abdominal wall reconstruction due to the limitations of synthetic meshes in many clinical situations. However, relatively little is known so far about their comparative mechanical characteristics and performance after defect repair. We therefore investigated three most commonly used porcine-derived ...

The purpose of this study was to investigate the clinical effects of porcine acellular dermal matrix combined with autoskin grafting on full-thickness skin defects using long-term clinical follow-up study and histologic examination. One hundred fifty-two patients with deep burn or trauma hospitalized from February 2000 to July 2003 were repaired with ...

Introduction: One of the most devastating complications of deep burn injuries to the hand and finger is the exposure of joint, tendon, and neurovascular structures. The inevitable consequence of such injuries is severe deformity, often requiring joint fusions and digital amputations. Complicating this scenario is the anatomic limitation of few local and reliable soft tissue flaps available for ...

Surgeons have used cryopreserved vascular allografts successfully for many years to treat arterial occlusive disease and to repair arterial aneurysms. Vascular allografts demonstrate high patency rates but contain viable cells, which may evoke a rejection response following implantation. Removing the cells could prevent such a response and negate the need ...

This study investigated the potential of the decellularized human umbilical vein (HUV) as an allogeneic, acellular extracellular matrix (ECM) scaffold for engineering the vocal fold lamina propria in vitro. HUV specimens with Wharton's jelly on the abluminal surface were uniformly dissected from native umbilical cords using an automated procedure and subjected to a novel ...

BACKGROUND: Complex abdominal wall defects can present a significant challenge to the reconstructive surgeon. In 2003, acellular dermal matrix (ADM) was introduced as an alternative to synthetic materials with suggestions that it has improved capacity to integrate with surrounding tissues with less inclination towards infection, erosion, extrusion, ...