Vol. 218, No. 5, May 2014
convincing evidence to cause us to change our current practice. As for the comparative effectiveness of our technique and the Rives-Stoppa repair, only a prospective, randomized controlled trial could definitively demonstrate the superiority of one technique over the other. Much of what the author of the letter to the editor asserts about abdominal wall reconstruction techniques represents historically conventional opinions derived from less recent literature, much of which is incomplete, underpowered, and with limited follow-up. Our study has one of the largest patient populations and longest follow-up for complex abdominal wall reconstruction to date. We have provided actual data from our institution that was meticulously collected, analyzed, and published in a peer-reviewed article. We believe this type of evidence, rather than opinion and conjecture, is what is needed to advance the field of complex abdominal wall reconstruction. We encourage the development of similar studies with complex patients and long follow-up to provide objective evidence about abdominal wall reconstruction. Although we are proud to report the outcomes our surgeons have achieved in an exceedingly challenging patient population, we enthusiastically welcome the prospect that collective future efforts might change the best practices for managing these patients and perhaps offer safer and more effective repair techniques for this challenging patient cohort. REFERENCES 1. Butler CE, Langstein HN, Kronowitz SJ. Pelvic, abdominal, and chest wall reconstruction with AlloDerm in patients at increased risk for mesh-related complications. Plast Reconstr Surg 2005;116:1263e1275. 2. Butler CE. The role of bioprosthetics in abdominal wall reconstruction. Clin Plast Surg 2006;33:199e211. 3. Said HK, Bevers M, Butler CE. Reconstruction of the pelvic floor and perineum with human acellular dermal matrix and thigh flaps following pelvic exenteration. Gynecol Oncol 2007;107:578e582. 4. Burns N, Rios CN, Jaffari MV, et al. Ventral hernia repair with porcine vs human acellular dermal matrices. J Am Coll Surg 2008;207[Suppl]:S66eS67. 5. Nemeth NL, Butler CE. Complex torso reconstruction with human acellular dermal matrix: long-term clinical follow-up. Plast Reconstr Surg 2009;123:192e196. 6. Boehmler JH 4th, Butler CE, Ensor J, Kronowitz SJ. Outcomes of various techniques of abdominal fascia closure after TRAM flap breast reconstruction. Plast Reconstr Surg 2009;123:773e781. 7. Mahabir RC, Butler CE. Stabilization of the chest wall: autologous and alloplastic reconstructions. Semin Plast Surg 2011;25:34e42. 8. Altman AM, Abdul Khalek FJ, Alt EU, Butler CE. Adopose tissue-derived stem cells enhance bioprosthetic mesh repair of ventral hernias. Plast Reconstr Surg 2010;126:845e854. 9. Butler CE, Burns NK, Campbell KT, et al. Comparison of cross-linked and non-cross-linked porcine acellular dermal matrices for ventral hernia repair. J Am Coll Surg 2010;211: 368e376.
Letters
1083
10. Ventral Hernia Working Group, Breuing K, Butler CE, et al. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010;148:544e558. 11. Baumann DP, Butler CE. Component separation improves outcomes in VRAM flap donor sites with excessive fascial tension. Plast Reconstr Surg 2010;126:1573e1580. 12. Momoh AO, Kamat AM, Butler CE. Reconstruction of the pelvic floor with human acellular dermal matrix and omental flap following anterior pelvic exenteration. J Plast Reconstr Aesthet Surg 2010;63:2185e2187. 13. Campbell KT, Burns NK, Rios CN, et al. Human versusu non-cross-linked porcine acellular dermal matrix used for ventral hernia repair: comparison of in vivo fibrovascular remodeling and mechanical repair strength. Plast Reconstr Surg 2011;127:2321e2332. 14. Butler CE, Campbell KT. Minimally invasive component separation with inlay bioprosthetic mesh (MICSIB) for complex abdominal wall reconstruction. Plast Reconstr Surg 2011; 128:698e709. 15. Garvey PB, Bailey CM, Baumann DP, et al. Violation of the rectus complex is not a contraindication to component separation for abdominal wall reconstruction. J Am Coll Surg 2012; 214:131e139. 16. Campbell KT, Burns NK, Ensor J, Butler CE. Metrics of cellular and vascular infiltration of human acellular dermal matrix in ventral hernia repairs. Plast Reconstr Surg 2012; 129:888e896. 17. Ghali S, Turza KC, Baumann DP, Butler CE. Minimally invasive component separation results in fewer wound-healing complications than open component separation for large ventral hernia repairs. J Am Coll Surg 2012;214:981e989. 18. Itani KM, Rosen M, Vargo D, et al. Prospective study of singlestage repair of contaminated hernias using a biologic porcine tissue matrix: the RICH Study. Surgery 2012;152:498e505. 19. Turza KC, Butler CE. Adhesions and meshes: synthetic versus bioprosthetic. Plast Reconstr Surg 2012;130[Suppl 2]:206se213s. 20. Baumann DP, Butler CE. Bioprosthetic mesh in abdominal wall reconstruction. Semin Plast Surg 2012;26:18e24. 21. Clemens MW, Selber JC, Liu J, et al. Bovine versus porcine acellular dermal matrix for complex abdominal wall reconstruction. Plas Reconstr Surg 2013;131:71e79. 22. Butler CE, Baumann DP, Janis JE, Rosen MJ. Abdominal wall reconstruction. Curr Probl Surg 2013;50:557e586. 23. Booth JH, Garvey PB, Baumann DP, et al. Primary fascial closure with mesh reinforcement is superior to bridged mesh repair for abdominal wall reconstruction. J Am Coll Surg 2013;217:999e1009.
Disclosure Information: Nothing to disclose.
Mesh Prophylaxis to Prevent Parastomal Hernia Bernard Gardner, Venice, FL
MD, FACS
I read with interest the recent article by Lee and colleagues1 on the use of mesh to prevent parastomal hernias.
1084
Letters
We described many years ago, not original with us, the technique of retroperitoneal colostomy, which prevents parastomal hernia and prolapse.2 We also used the technique for ileostomy, when necessary, after total colectomy. The technique is simple and because suturing the mesocolon to the abdominal wall is not done, it is faster than traditional colostomy. After the peritoneum is placed over the colon, it remains fixed in this position and cannot herniate or prolapse. Same with the ileum.
J Am Coll Surg
REFERENCES 1. Lee L, Saleem A, Landry T, et al. Cost effectiveness of mesh prophylaxis to prevent parastomal hernia in patients undergoing permanent colostomy for rectal cancer. J Am Coll Surg 2014; 218:82e91. 2. Gardner B. Comment on: Aldrete JS. Diverting and venting colostomy techniques and colostomy closure. In: Nyhus LM, Baker RJ, eds. Mastery of Surgery. 2nd ed., Vol II. New York: Little Brown; 1992:1216e1217.
Disclosure Information: Nothing to disclose.
convincing evidence to cause us to change our current practice. As for the comparative effectiveness of our technique and the Rives-Stoppa repair, only a prospective, randomized controlled trial could definitively demonstrate the superiority of one technique over the other. Much of what the author of the letter to the editor asserts about abdominal wall reconstruction techniques represents historically conventional opinions derived from less recent literature, much of which is incomplete, underpowered, and with limited follow-up. Our study has one of the largest patient populations and longest follow-up for complex abdominal wall reconstruction to date. We have provided actual data from our institution that was meticulously collected, analyzed, and published in a peer-reviewed article. We believe this type of evidence, rather than opinion and conjecture, is what is needed to advance the field of complex abdominal wall reconstruction. We encourage the development of similar studies with complex patients and long follow-up to provide objective evidence about abdominal wall reconstruction. Although we are proud to report the outcomes our surgeons have achieved in an exceedingly challenging patient population, we enthusiastically welcome the prospect that collective future efforts might change the best practices for managing these patients and perhaps offer safer and more effective repair techniques for this challenging patient cohort. REFERENCES 1. Butler CE, Langstein HN, Kronowitz SJ. Pelvic, abdominal, and chest wall reconstruction with AlloDerm in patients at increased risk for mesh-related complications. Plast Reconstr Surg 2005;116:1263e1275. 2. Butler CE. The role of bioprosthetics in abdominal wall reconstruction. Clin Plast Surg 2006;33:199e211. 3. Said HK, Bevers M, Butler CE. Reconstruction of the pelvic floor and perineum with human acellular dermal matrix and thigh flaps following pelvic exenteration. Gynecol Oncol 2007;107:578e582. 4. Burns N, Rios CN, Jaffari MV, et al. Ventral hernia repair with porcine vs human acellular dermal matrices. J Am Coll Surg 2008;207[Suppl]:S66eS67. 5. Nemeth NL, Butler CE. Complex torso reconstruction with human acellular dermal matrix: long-term clinical follow-up. Plast Reconstr Surg 2009;123:192e196. 6. Boehmler JH 4th, Butler CE, Ensor J, Kronowitz SJ. Outcomes of various techniques of abdominal fascia closure after TRAM flap breast reconstruction. Plast Reconstr Surg 2009;123:773e781. 7. Mahabir RC, Butler CE. Stabilization of the chest wall: autologous and alloplastic reconstructions. Semin Plast Surg 2011;25:34e42. 8. Altman AM, Abdul Khalek FJ, Alt EU, Butler CE. Adopose tissue-derived stem cells enhance bioprosthetic mesh repair of ventral hernias. Plast Reconstr Surg 2010;126:845e854. 9. Butler CE, Burns NK, Campbell KT, et al. Comparison of cross-linked and non-cross-linked porcine acellular dermal matrices for ventral hernia repair. J Am Coll Surg 2010;211: 368e376.
Letters
1083
10. Ventral Hernia Working Group, Breuing K, Butler CE, et al. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010;148:544e558. 11. Baumann DP, Butler CE. Component separation improves outcomes in VRAM flap donor sites with excessive fascial tension. Plast Reconstr Surg 2010;126:1573e1580. 12. Momoh AO, Kamat AM, Butler CE. Reconstruction of the pelvic floor with human acellular dermal matrix and omental flap following anterior pelvic exenteration. J Plast Reconstr Aesthet Surg 2010;63:2185e2187. 13. Campbell KT, Burns NK, Rios CN, et al. Human versusu non-cross-linked porcine acellular dermal matrix used for ventral hernia repair: comparison of in vivo fibrovascular remodeling and mechanical repair strength. Plast Reconstr Surg 2011;127:2321e2332. 14. Butler CE, Campbell KT. Minimally invasive component separation with inlay bioprosthetic mesh (MICSIB) for complex abdominal wall reconstruction. Plast Reconstr Surg 2011; 128:698e709. 15. Garvey PB, Bailey CM, Baumann DP, et al. Violation of the rectus complex is not a contraindication to component separation for abdominal wall reconstruction. J Am Coll Surg 2012; 214:131e139. 16. Campbell KT, Burns NK, Ensor J, Butler CE. Metrics of cellular and vascular infiltration of human acellular dermal matrix in ventral hernia repairs. Plast Reconstr Surg 2012; 129:888e896. 17. Ghali S, Turza KC, Baumann DP, Butler CE. Minimally invasive component separation results in fewer wound-healing complications than open component separation for large ventral hernia repairs. J Am Coll Surg 2012;214:981e989. 18. Itani KM, Rosen M, Vargo D, et al. Prospective study of singlestage repair of contaminated hernias using a biologic porcine tissue matrix: the RICH Study. Surgery 2012;152:498e505. 19. Turza KC, Butler CE. Adhesions and meshes: synthetic versus bioprosthetic. Plast Reconstr Surg 2012;130[Suppl 2]:206se213s. 20. Baumann DP, Butler CE. Bioprosthetic mesh in abdominal wall reconstruction. Semin Plast Surg 2012;26:18e24. 21. Clemens MW, Selber JC, Liu J, et al. Bovine versus porcine acellular dermal matrix for complex abdominal wall reconstruction. Plas Reconstr Surg 2013;131:71e79. 22. Butler CE, Baumann DP, Janis JE, Rosen MJ. Abdominal wall reconstruction. Curr Probl Surg 2013;50:557e586. 23. Booth JH, Garvey PB, Baumann DP, et al. Primary fascial closure with mesh reinforcement is superior to bridged mesh repair for abdominal wall reconstruction. J Am Coll Surg 2013;217:999e1009.
Disclosure Information: Nothing to disclose.
Mesh Prophylaxis to Prevent Parastomal Hernia Bernard Gardner, Venice, FL
MD, FACS
I read with interest the recent article by Lee and colleagues1 on the use of mesh to prevent parastomal hernias.
1084
Letters
We described many years ago, not original with us, the technique of retroperitoneal colostomy, which prevents parastomal hernia and prolapse.2 We also used the technique for ileostomy, when necessary, after total colectomy. The technique is simple and because suturing the mesocolon to the abdominal wall is not done, it is faster than traditional colostomy. After the peritoneum is placed over the colon, it remains fixed in this position and cannot herniate or prolapse. Same with the ileum.
J Am Coll Surg
REFERENCES 1. Lee L, Saleem A, Landry T, et al. Cost effectiveness of mesh prophylaxis to prevent parastomal hernia in patients undergoing permanent colostomy for rectal cancer. J Am Coll Surg 2014; 218:82e91. 2. Gardner B. Comment on: Aldrete JS. Diverting and venting colostomy techniques and colostomy closure. In: Nyhus LM, Baker RJ, eds. Mastery of Surgery. 2nd ed., Vol II. New York: Little Brown; 1992:1216e1217.
Disclosure Information: Nothing to disclose.
