Pelvic Floor Reconstruction Using Human Acellular Dermal Matrix After Cylindrical Abdominoperineal Resection

PURPOSE: Patients who undergo cylindrical abdominoperineal resection can have significant complications, especially those who require pelvic reconstruction using myocutaneous flaps. Reconstruction using a biomaterial may be a novel alternative. The purpose of this study is to report the initial results of pelvic reconstruction using human acellular dermal matrix after cylindrical abdominoperineal resection. METHODS: Between January 2008 and February 2009, pelvic floor reconstruction was performed in 12 consecutive patients who underwent cylindrical abdominoperineal resection for advanced ultralow rectal cancer. RESULTS: Two weeks after the operation, primary complete healing of the perineal wound was seen in 11 patients. At a median follow-up of 8 months, there was no perineal wound breakdown, bulge, or herniation. One patient had an asymptomatic seroma, one patient had a perineal wound infection, and 4 patients had perineal pain that resolved. CONCLUSIONS: Human acellular dermal matrix provided a safe alternative for the reconstruction of large pelvic defect in the patients after cylindrical abdominoperineal resection.