Midwest Surgical AssociationSingle institutional experience using biological mesh for abdominal wall reconstruction
Section snippets
Methods
The study was carried out following guidelines set by our Institutional Review Board. A retrospective study design was used to evaluate outcomes of patients having received PAD or ADM biologic mesh as part of a ventral abdominal wall hernia repair. All parastomal, inguinal, and laparoscopic hernia repairs were excluded. Records of all pieces of ADM dispensed by our blood bank and of all pieces of PAD dispensed by our operating room facilities were queried. The decision to use PAD or ADM was
Results
A total of 251 patients underwent complex ventral hernia repair between January 2007 and June 2011 at our institution, a tertiary care hospital. Patients were divided into 2 groups, repair with PAD (124) or ADM (127). In the PAD group, the average age was 61.9 ± 13.7 years, while the average age in the ADM group was 61.3 ± 14.6 years (P = .76). There were 52% men in the PAD group and 43% men in the ADM (P = .15) group. The average body mass index (BMI) between the 2 groups was 30.7 ± 7.6 versus
Comments
Abdominal wall reconstruction in the presence of contamination and infection still persists as a challenge to the general surgeon. The use of prosthetic mesh is still somewhat contraindicated in abdominal wall reconstruction in the setting of enterocutaneous fistula, wound infections, clean contaminated and contaminated dirty surgical fields, although recent literature may debate the use of prosthetics in contaminated fields.6, 7 According to a recent retrospective analysis by Souza and
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Cited by (28)
Repair of complex abdominal wall hernias with a cross-linked porcine acellular matrix: cross-sectional results of a Dutch cohort study
2019, International Journal of SurgeryCitation Excerpt :After decellularization and degradation of the porcine dermal tissue, a 3D structure of collagen remains. Thereafter, the collagen fibers are chemically cross-linked with hexamethylene diisocyanate to increase the strength of the mesh and to slow-down the degradation of the mesh [3,6]. During degradation, ingrowth of host fibroblasts and collagen replacement can take place.
Scaffolds for abdominal wall reconstruction
2019, Handbook of Tissue Engineering Scaffolds: Volume TwoBiological meshes for abdominal hernia: Lack of evidence-based recommendations for clinical use
2018, International Journal of SurgeryRisk-adjusted adverse outcomes in complex abdominal wall hernia repair with biologic mesh: A case series of 140 patients
2017, International Journal of SurgeryCitation Excerpt :Clemens et al. [21] studied 120 patients who underwent inlay abdominal wall reconstruction with porcine ADM and reported that both ADM types were associated with similar postoperative surgical outcomes; however, porcine mesh had more intraoperative device failure. Multivariable analysis of 251 patients who underwent complex ventral hernia repair with either porcine or human-derived mesh [7], found that obesity, surgical technique and mesh type were significant independent predictors of time or recurrence. In 2009, Diaz et al. reported a multicenter study of 240 patients undergoing complex ventral hernia repair with biologic mesh and found that BMI >30, and surgical site infection, takedown of stoma and fistula repair were independent predictive factors for hernia recurrence [15].
Comment on: Biologic mesh in ventral hernia repair: Outcomes, recurrence, and charge analysis
2017, Surgery (United States)
All authors have no conflict of interest, there has been no support from industry, no grants, no sponsors.