Parastomal
hernias are a common complication after
ileostomy or
colostomy formation and can lead to complications, such as
intestinal obstruction and strangulation. When a parastomal
hernia presents, repair of the defect can pose a challenge to the surgeon to choose a repair that both reduces complications and recurrence rates. We present three cases of parastomal
hernia repair using acellular dermal matrix (
AlloDerm) as reinforcement to the primary
hernia repair. We prospectively followed three patients who presented with parastomal
hernia after
ostomy formation in 2001-2002. The patients underwent repair of the parastomal
hernia using primary fascial repair with reinforcement using
AlloDerm as an on-lay patch. Two patients were followed for 6 months and 1 year, respectively, and remained
hernia-free. One patient presented 8 months later with symptoms of
intestinal obstruction that were relieved by nasogastric tube
decompression and bowel rest. The patient subsequently returned 3 months later with
intestinal obstruction and recurrent parastomal
hernia that necessitated an operation for relocation of the stoma and repeat
hernia repair. Repair of parastomal
hernias using
AlloDerm acellular dermal matrix as a substitute for a synthetic graft showed resilience to
infection and, more importantly, tolerated exposure in an open
wound without having to be removed. Larger studies with longer follow-up are needed to see if this material reduces the incidence of
hernia recurrence.