Top

Published in:

01-06-2017 | Case Report

Delayed type IV hypersensitivity reaction to porcine acellular dermal matrix masquerading as infection resulting in multiple debridements

Authors: P. Vedak, J. St. John, A. Watson, L. Garibyan, M. C. Mihm, R. M. Nazarian, P. C. Levins, C. L. Cetrulo Jr., P. Schalock, D. Kroshinsky

Published in: Hernia | Issue 3/2017

Abstract

Introduction

Delayed type IV hypersensitivity reactions are well established in the surgical setting with respect to external exposure via topical antibiotics and internal exposure via synthetic materials. In contrast, biologic matrix is derived from decellularized human or animal tissues and is consequently believed to elicit a minimal host inflammatory response.

Objective

We report a case of delayed type IV hypersensitivity reaction secondary to a biologic comprised of porcine-derived acellular dermal matrix, [Strattice™].

Conclusions

While biologic matrix is often preferred over synthetic mesh due to its decreased risk for infection, this case emphasizes that potential for hypersensitivity to the material persists. Type IV hypersensitivity reactions should be included in the differential diagnosis for suspected post-operative infections.

Cevasco M, Itani KM (2012) Ventral hernia repair with synthetic, composite, and biologic mesh: characteristics, indications and infection profile. Surg Infect (Larchmt) 13(4):209–215CrossRef

Chen CC, Ridgeway B, Paraiso MF (2007) Biologic grafts and synthetic meshes in pelvic reconstructive surgery. Clin Obstet Gynecol 50(2):383–411CrossRefPubMed

Xu H, Wan H, Zuo W, Sun W, Owens RT, Harper JR, Ayares DL, McQuillan DJ (2009) A porcine-derived acellular dermal scaffold that supports soft tissue regeneration: removal of terminal galactose-alpha-(1,3)-galactose and retention of matrix structure. Tissue Eng Part A 15(7):1807–1819CrossRefPubMed

Ganske I, Hoyler M, Fox SE, Morris DJ, Lin SJ, Slavin SA (2014) Delayed hypersensitivity reaction to acellular dermal matrix in breast reconstruction: the red breast syndrome? Ann Plast Surg 73(Suppl 2):S139–S143CrossRefPubMed

Evgeniou E, Cain H, Amonkar S, Hennessy C, Bhaskar P (2013) Complications in immediate breast reconstruction using Strattice™. Eur J Plast Surg 36(5):301–306CrossRef

Salzberg CA, Dunavant C, Nocera N (2013) Immediate breast reconstruction using porcine acellular dermal matrix (Strattice^TM): long-term outcomes and complications. J Plast Reconstr Aesthet Surg 66(3):323–328CrossRefPubMed

Kunda LD, Stidham KR, Inserra MM, Roland PS, Franklin D, Roberson JB Jr (2006) Silicone allergy: a new cause for cochlear implant extrusion and its management. Otol Neurotol 27(8):1078–1082CrossRefPubMed

Badylak SF (2014) Decellularized allogeneic and xenogeneic tissue as a bioscaffold for regenerative medicine: factors that influence the host response. Ann Biomed Eng 42(7):1517–1527CrossRefPubMed

Title: Delayed type IV hypersensitivity reaction to porcine acellular dermal matrix masquerading as infection resulting in multiple debridements
Authors: P. Vedak
J. St. John
A. Watson
L. Garibyan
M. C. Mihm
R. M. Nazarian
P. C. Levins
C. L. Cetrulo Jr.
P. Schalock
D. Kroshinsky
Publication date: 01-06-2017
Publisher: Springer Paris
Published in: Hernia / Issue 3/2017
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-015-1440-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Delayed type IV hypersensitivity reaction to porcine acellular dermal matrix masquerading as infection resulting in multiple debridements

Abstract

Introduction

Objective

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Objective

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2017

Quantitative assessment of the impacts of stoppa repair and total extraperitoneal repair on the lower extremity muscular functions in cases of unilateral inguinal hernia: a randomized controlled study

A randomized clinical study on postoperative pain comparing between the supraglottic airway device and endotracheal tubing in transabdominal preperitoneal repair (TAPP)

Sudden death caused by acute pulmonary embolism after laparoscopic total extraperitoneal inguinal hernia repair: a case report and literature review

Modified single-port vs two-port laparoscopic herniorrhaphy for children with concealed deferent duct: a retrospective study from a single institution

Totally extraperitoneal (TEP) bilateral hernioplasty using the Single Site® robotic da Vinci platform (DV-SS TEP): description of the technique and preliminary results

Bridging with reduced overlap: fixation and peritoneal grip can prevent slippage of DIS class A meshes