Intestinal rehabilitation for short-bowel syndrome is an integral part of modern intestinal transplant programmes. The mortality of patients with short-bowel syndrome is most significant in individuals with a residual small bowel of <50 cm, as shown by a 5-year survival rate of 57%.¹ Total parenteral nutrition and intestinal transplantation are options to extend life but are still plagued by serious complications and, in the case of transplantation, immunosuppression. As an alternative, several bowel elongation procedures have been described,^2–4 but have had limited clinical success and new techniques are warranted. The minimum length of bowel required to allow sufficient absorption of nutrients has not been confirmed.^1,5 Elongation of even a few centimetres may allow these patients to receive nutritional rehabilitation and become independent from total parenteral nutrition, and possibly avoid transplantation. We hypothesised that an acellular dermal matrix …