Outcomes of a new slowly resorbable biosynthetic mesh (Phasix™) in potentially contaminated incisional hernias: A prospective, multi-center, single-arm trial.


Journal

International journal of surgery (London, England)
ISSN: 1743-9159
Titre abrégé: Int J Surg
Pays: United States
ID NLM: 101228232

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 24 05 2020
revised: 21 08 2020
accepted: 26 08 2020
pubmed: 16 9 2020
medline: 3 3 2021
entrez: 15 9 2020
Statut: ppublish

Résumé

Resorbable biomaterials have been developed to reduce the amount of foreign material remaining in the body after hernia repair over the long-term. However, on the short-term, these resorbable materials should render acceptable results with regard to complications, infections, and reoperations to be considered for repair. Additionally, the rate of resorption should not be any faster than collagen deposition and maturation; leading to early hernia recurrence. Therefore, the objective of this study was to collect data on the short-term performance of a new resorbable biosynthetic mesh (Phasix™) in patients requiring Ventral Hernia Working Group (VHWG) Grade 3 midline incisional hernia repair. A prospective, multi-center, single-arm trial was conducted at surgical departments in 15 hospitals across Europe. Patients aged ≥18, scheduled to undergo elective Ventral Hernia Working Group Grade 3 hernia repair of a hernia larger than 10 cm In total, 84 patients were treated with Phasix™ Mesh. Twenty-two patients (26.2%) developed 32 surgical site occurrences. These included 11 surgical site infections, 9 wound dehiscences, 7 seromas, 2 hematomas, 2 skin necroses, and 1 fistula. No significant differences in surgical site occurrence development were found between groups repaired with or without component separation technique, and between clean-contaminated or contaminated wound sites. At three months, there were no hernia recurrences. Phasix™ Mesh demonstrated acceptable postoperative surgical site occurrence rates in patients with a Ventral Hernia Working Group Grade 3 hernia. Longer follow-up is needed to evaluate the recurrence rate and the effects on quality of life. This study is ongoing through 24 months of follow-up.

Sections du résumé

BACKGROUND BACKGROUND
Resorbable biomaterials have been developed to reduce the amount of foreign material remaining in the body after hernia repair over the long-term. However, on the short-term, these resorbable materials should render acceptable results with regard to complications, infections, and reoperations to be considered for repair. Additionally, the rate of resorption should not be any faster than collagen deposition and maturation; leading to early hernia recurrence. Therefore, the objective of this study was to collect data on the short-term performance of a new resorbable biosynthetic mesh (Phasix™) in patients requiring Ventral Hernia Working Group (VHWG) Grade 3 midline incisional hernia repair.
MATERIALS AND METHODS METHODS
A prospective, multi-center, single-arm trial was conducted at surgical departments in 15 hospitals across Europe. Patients aged ≥18, scheduled to undergo elective Ventral Hernia Working Group Grade 3 hernia repair of a hernia larger than 10 cm
RESULTS RESULTS
In total, 84 patients were treated with Phasix™ Mesh. Twenty-two patients (26.2%) developed 32 surgical site occurrences. These included 11 surgical site infections, 9 wound dehiscences, 7 seromas, 2 hematomas, 2 skin necroses, and 1 fistula. No significant differences in surgical site occurrence development were found between groups repaired with or without component separation technique, and between clean-contaminated or contaminated wound sites. At three months, there were no hernia recurrences.
CONCLUSION CONCLUSIONS
Phasix™ Mesh demonstrated acceptable postoperative surgical site occurrence rates in patients with a Ventral Hernia Working Group Grade 3 hernia. Longer follow-up is needed to evaluate the recurrence rate and the effects on quality of life. This study is ongoing through 24 months of follow-up.

Identifiants

pubmed: 32931978
pii: S1743-9191(20)30668-3
doi: 10.1016/j.ijsu.2020.08.053
pii:
doi:

Substances chimiques

Biocompatible Materials 0

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

31-36

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Becton Dickinson (BD) arranged travel and accommodation for some authors to attend investigators meetings. Additionally, some authors received grants for trainings, educational activities, and to support research work in abdominal wall reconstruction. Some authors have provided additional consultancy services to non-public entities other than the sponsor in the 36 months prior to submission.

Auteurs

Mathilde Mj van Rooijen (MM)

Erasmus University Medical Centre Rotterdam, Department of Surgery, Rotterdam, The Netherlands. Electronic address: m.vanrooijen@erasmusmc.nl.

An P Jairam (AP)

Erasmus University Medical Centre Rotterdam, Department of Surgery, Rotterdam, The Netherlands.

Tim Tollens (T)

Imelda Hospital, Department of General Surgery, Bonheiden, Belgium.

Lars N Jørgensen (LN)

University of Copenhagen, Bispebjerg Hospital, Department of Surgery, Copenhagen, Denmark.

Tammo S de Vries Reilingh (TS)

Elkerliek Hospital, Department of Surgery, Helmond, The Netherlands.

Guillaume Piessen (G)

University Hospital Lille, Department of Surgery, Lille, France.

Ferdinand Köckerling (F)

Vivantes Klinikum Spandau, Department of Surgery, Berlin, Germany.

Marc Miserez (M)

University Hospital Leuven, Department of Abdominal Surgery, Leuven, Belgium.

Alastair Cj Windsor (AC)

University College London Hospital, Department of Colorectal Surgery, London, United Kingdom.

Frederik Berrevoet (F)

University Hospital Ghent, Department of General and Hepatobiliary Surgery, Ghent, Belgium.

René H Fortelny (RH)

Wilhelminenhospital, Department of General, Visceral and Oncologic Surgery, Vienna, Austria.

Bertrand Dousset (B)

Hôpital Cochin, Department of Digestive, Hepatobiliary and Endocrine Surgery, Paris, France.

Guido Woeste (G)

Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt Am Main, Germany.

Henderik L van Westreenen (HL)

Isala Zwolle, Department of Surgery, Zwolle, The Netherlands.

Francesco Gossetti (F)

Università di Roma Sapienza, Rome, Italy.

Johan F Lange (JF)

Erasmus University Medical Centre Rotterdam, Department of Surgery, Rotterdam, The Netherlands; IJsselland Ziekenhuis, Department of Surgery, Capelle Aan Den Ijssel, The Netherlands.

Geert Wm Tetteroo (GW)

IJsselland Ziekenhuis, Department of Surgery, Capelle Aan Den Ijssel, The Netherlands.

Andreas Koch (A)

Chirurgische Praxis Cottbus, Cottbus Area, Germany.

Leonard F Kroese (LF)

Erasmus University Medical Centre Rotterdam, Department of Surgery, Rotterdam, The Netherlands.

Johannes Jeekel (J)

Erasmus University Medical Centre Rotterdam, Department of Surgery, Rotterdam, The Netherlands.

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