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Human Acellular Dermal Matrix

Human acellular dermal matrix (hADM) is donated human dermis processed to remove cells while retaining a collagen-rich scaffold. Early AlloDerm burn experience demonstrated host-cell infiltration and neovascularization beneath a skin autograft; it does not establish equivalent outcomes in the urethra, tunica albuginea or pelvic floor.[1]

Identify the actual product and intended use. Human dermis, human pericardium, porcine dermis and porcine small-intestinal submucosa are different materials. Processing, preservation, thickness and labeling also vary between products. See Tutoplast allografts, porcine matrices and bovine grafts.

AlloDerm SELECT: labeling and preparation​

The US May 2025 instructions describe a human tissue product regulated under 21 CFR Part 1271, intended for repair or replacement of inadequate integument and other homologous uses. This classification does not establish an FDA-approved indication for every reported urologic application. It is not a dural substitute.[2]

AlloDerm SELECT is supplied hydrated and terminally sterilized by electron-beam irradiation, with a stated sterility-assurance level of 10⁻³. Despite the ready-to-use designation, soak it for at least two minutes in room-temperature sterile saline or lactated Ringer's solution. The instructions allow up to four hours in that sterile solution before implantation. Place the dermal side against the most vascular tissue; use the label's orientation method. These instructions should not be transferred to older freeze-dried AlloDerm or another brand.[2]

Do not use in a patient sensitive to polysorbate 20 or an antibiotic listed on the package. Do not use dry tissue, compromised packaging, an unacceptable temperature indicator or expired material. Do not reuse or resterilize; retain donor/product traceability.[2]

The manufacturer's current safety information identifies infection, seroma, dehiscence, immune reactions and graft failure as possible complications. Donor screening and processing reduce but cannot eliminate transmission risk. Poor perfusion, radiation and impaired healing require particular assessment; an acellular graft does not supply its own blood flow or substitute for infection control.[3]

Clinical role in reconstructive urology​

Urethral reconstruction​

EAU guidance favors available buccal or lingual mucosa when a urethral graft is needed. Evidence for cell-free matrices remains heterogeneous. Its weak recommendation advises against these matrices with extensive spongiofibrosis, previous failed urethroplasty or a stricture longer than 4 cm. That restriction is not proof that shorter strictures are routinely suitable, and evidence for one acellular material cannot be assigned to another brand.[4]

See urethral reconstruction principles for selection and operative planning.

Peyronie's disease and corporal reconstruction​

There is no proven best graft for Peyronie's surgery. Selection depends on deformity, erectile function, tissue characteristics and the operation; grafting can cause erectile dysfunction, recurrent curvature or shortening. Current EAU guidance does not establish AlloDerm as the preferred material, or buccal mucosa as superior for preserving erections.[5]

A pericardial or small-intestinal-submucosa series is not an hADM series. Specialized corporal or genital reconstruction requires evidence and labeling specific to the proposed material and use. See plaque incision and grafting for the procedural discussion.

Abdominal wall and parastomal reconstruction​

Contamination alone does not establish biological-mesh superiority. In a 253-patient randomized trial of elective single-stage class II–III ventral hernia repair, all repairs had retromuscular mesh and fascial closure. Two-year recurrence was 26/127 with non-crosslinked porcine dermis versus 7/126 with polypropylene, without a demonstrated difference in surgical-site occurrences requiring intervention. This was not an AlloDerm trial, and its results do not establish outcomes for bridging, other planes or urinary-diversion-specific hernias.[6]

Use the mesh material hub and the relevant reconstruction page to distinguish repair technique from material choice.

Cosmetic penile girth​

EAU guidance recommends against grafts for penile girth enhancement because they remain experimental. Cosmetic wrapping should not be presented as an established use of hADM or supported by unrelated reconstructive series.[7] See dermal-fat grafts and AlloDerm wraps.

References​

1. Wainwright DJ. Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns. Burns. 1995;21:243–248. doi:10.1016/0305-4179(95)93866-i.

2. LifeCell/AbbVie. AlloDerm SELECT Regenerative Tissue Matrix: Instructions for Use. 121P0652 Rev N, May 2025. Product and package-specific instructions apply.

3. AbbVie. AlloDerm SELECT resources and important safety information. Accessed September 2026.

4. European Association of Urology. Urethral Strictures: Tissue Transfer, sections 9.3–9.4. 2026.

5. European Association of Urology. Sexual and Reproductive Health: Penile Curvature, tunical lengthening and surgical recommendations. 2026.

6. Rosen MJ, Krpata DM, Petro CC, et al. Biologic vs synthetic mesh for single-stage repair of contaminated ventral hernias: a randomized clinical trial. JAMA Surg. 2022;157:293–301. doi:10.1001/jamasurg.2021.6902.

7. European Association of Urology. Sexual and Reproductive Health: Penile Size Abnormalities and Dysmorphophobia, grafting and penile-girth recommendations. 2026.