The worst-case scenario: Bridging repair with a biologic mesh in high-risk patients with very large abdominal wall hernias-a prospective multicenter study.
Abdominal Wall
/ diagnostic imaging
Adult
Aged
Animals
Biocompatible Materials
/ adverse effects
Cattle
Female
Follow-Up Studies
Hernia, Ventral
/ diagnosis
Herniorrhaphy
/ adverse effects
Humans
Male
Middle Aged
Prospective Studies
Recurrence
Risk Factors
Surgical Mesh
/ adverse effects
Surgical Wound Infection
/ epidemiology
Tomography, X-Ray Computed
Treatment Outcome
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
25
05
2020
revised:
25
08
2020
accepted:
31
08
2020
pubmed:
18
10
2020
medline:
23
4
2021
entrez:
17
10
2020
Statut:
ppublish
Résumé
While modern techniques allow midline fascial closure for most abdominal hernias, a bridge repair with mesh may be the only alternative in very large defects. When the risk of infection is high, the use of prosthetic mesh is controversial. We aim to examine outcomes after bridge repair of very large abdominal hernias at high risk for postoperative infection with a second-generation biologic mesh. Prospective, multicenter, single-arm study of patients with very large abdominal hernias who received bridge repair with a neonatal bovine dermis mesh. Primary outcome was hernia recurrence, as identified on computed tomography 1 year after the operation. Secondary outcomes included mesh laxity, surgical site occurrences, and any other mesh-related complications. Independent risk factors of the outcomes were determined by univariate and multivariable analyses. A total of 117 bridge repair patients were enrolled with a mean defect size of 442.5 ± 254.2 cm In patients with very large abdominal hernias and at high risk for postoperative infection, who cannot undergo midline fascial closure, a bridge repair with neonatal bovine dermis mesh offers an acceptable profile in terms of hernia recurrence and wound occurrences.
Sections du résumé
BACKGROUND
While modern techniques allow midline fascial closure for most abdominal hernias, a bridge repair with mesh may be the only alternative in very large defects. When the risk of infection is high, the use of prosthetic mesh is controversial. We aim to examine outcomes after bridge repair of very large abdominal hernias at high risk for postoperative infection with a second-generation biologic mesh.
METHODS
Prospective, multicenter, single-arm study of patients with very large abdominal hernias who received bridge repair with a neonatal bovine dermis mesh. Primary outcome was hernia recurrence, as identified on computed tomography 1 year after the operation. Secondary outcomes included mesh laxity, surgical site occurrences, and any other mesh-related complications. Independent risk factors of the outcomes were determined by univariate and multivariable analyses.
RESULTS
A total of 117 bridge repair patients were enrolled with a mean defect size of 442.5 ± 254.2 cm
CONCLUSION
In patients with very large abdominal hernias and at high risk for postoperative infection, who cannot undergo midline fascial closure, a bridge repair with neonatal bovine dermis mesh offers an acceptable profile in terms of hernia recurrence and wound occurrences.
Identifiants
pubmed: 33066982
pii: S0039-6060(20)30603-6
doi: 10.1016/j.surg.2020.08.036
pii:
doi:
Substances chimiques
Biocompatible Materials
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
318-324Informations de copyright
Copyright © 2020. Published by Elsevier Inc.