Clairissa Mulloy,I.  Hodgdon,J.  Paige,Michael W.  Cook,
Use of Cutis Graft as Biologic Prosthesis in Complicated Abdominal Closures: A Case Report
Journal of Clinical and Medical Case Reports
2020
2733-2268
http://dx.doi.org/10.31487/j.JCMCR.2020.01.07
https://www.sciencerepository.org/use-of-cutis-graft-as-biologic-prosthesis-in-complicated-abdominal-closures_JCMCR-2020-1-107 
Abstract: Background: Loss of domain, fascial separation, and wound contamination are all recognized challenges
of complex abdominal wall reconstruction. Often, traditional therapies, such as fascial advancement, mesh
reinforcement, and the use of bio-prostheses for infection are insufficient. Recently, we have investigated
using cutis as an alternative therapy. We present the case of a 61-year old male treated in such a manner.
Methods: Our patient presented to our facility with a fascial defect of 30 by 40 cm, and an infected skin
graft after undergoing an exploratory laparotomy for a gunshot wound at an outside hospital. During his
course, he failed multiple traditional therapies, leaving him with a large open wound, four paired
enterocutaneous fistulae, and a cholecystocutaneous fistula. We repaired his fistulae, performed a staged
fascial closure, and reinforced it by placing an autograft of de-epithelialized dermis over it, bridging some
areas of fascia.
Results: The patient had rapid incorporation of his cutis graft, with granulation over the graft within 72
hours. Within three months, all wounds had healed, and the patient had fully recovered.
Conclusions: Cutis autograft as a means for reinforcing abdominal wall closure is a versatile tool in the
armamentarium of the surgeon to treat complex abdominal wall reconstruction. In the setting of failure of
traditional therapies for fascial closure, it can potentially help with simultaneous bridging and
reinforcement, demonstrating the strength of this type of repairKeywords: cutis graft, cutis hernia repair, ventral hernia repair, abdominal wall reconstruction, biologic mesh, enterocutaneous fistula, enteroatmospheric fistula