Biologic grafts for ventral hernia repair: a systematic review

Slater, Nicholas J.; Kolk, Marion van der; Hendriks, T.; Goor, Harry van; Bleichrodt, Robert P.

doi:10.1016/j.amjsurg.2012.05.028

Cited by 122 publications

(94 citation statements)

References 65 publications

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“…10 It is sold in sheets, allowing it to be cut to shape, and provides the largest grafts available (maximum size, 28 × 40 cm). 8,10 In animal studies, a porcine dermal collagen implant produced a substantially weaker inflammatory response and less extensive, less dense adhesions. [10][11][12] Although it had significantly lower tensile strength than polypropylene at 30 days after being implanted, at 90 days there was no statistically significant difference.…”

Section: Umit Ozcelik Et Al/experimental and Clinical Transplantationmentioning

confidence: 99%

“…6 After cell removal, it is sterilized by gamma irradiation and packaged in a hydrated state that makes it usable immediately without any preparation. 8 This prosthesis is treated with hexamethylene diisocyanate to increase collagen cross-linking and decrease biodegradability, which might be accelerated in contaminated wounds. 6,8 Porcine dermis is the closest to human dermis and it is not cytotoxic, hemolytic, pyrogenic, or allergenic, and it does not elicit a foreign body response.…”

Section: Umit Ozcelik Et Al/experimental and Clinical Transplantationmentioning

confidence: 99%

“…8 This prosthesis is treated with hexamethylene diisocyanate to increase collagen cross-linking and decrease biodegradability, which might be accelerated in contaminated wounds. 6,8 Porcine dermis is the closest to human dermis and it is not cytotoxic, hemolytic, pyrogenic, or allergenic, and it does not elicit a foreign body response. 10 It is colonized by host tissue cells and blood vessels that minimize the risk of infection.…”

Section: Umit Ozcelik Et Al/experimental and Clinical Transplantationmentioning

confidence: 99%

“…7 Biological mesh prostheses allow neovascularization and regeneration due to infiltration of native fibroblasts and they are incorporated into the surrounding tissue. 6,8 During incorporation, they gradually are degraded and generate a new, metabolically active neofascia to withstand the mechanical forces of the abdominal wall. 7,8 The use of synthetic mesh in transplant patients is controversial.…”

Section: Introductionmentioning

confidence: 99%

“…6,8 During incorporation, they gradually are degraded and generate a new, metabolically active neofascia to withstand the mechanical forces of the abdominal wall. 7,8 The use of synthetic mesh in transplant patients is controversial. Simple, small, and noninfected incisional hernias may be repaired either primarily or with polypropylene mesh with good results.…”

Section: Introductionmentioning

confidence: 99%

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2015

Exp Clin Transplant

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Objectives: The use of synthetic mesh in transplant patients is controversial. Recent studies have shown that biological prostheses have a greater ability to integrate into tissues, resist bacterial colonization, and reduce cytotoxic or allergic reactions, and provide similar functional results, compared with synthetic prostheses. Biological prostheses do not require any reduction or discontinuation of immunosuppressive therapy. We present the case of a kidney and pancreas transplant recipient who had a giant incisional hernia that was treated successfully with a biological prosthesis. Case Report: A 40-year-old male kidney and pancreas transplant recipient was admitted to our hospital with a giant incisional hernia, 2 years after transplant. The defect on the abdominal wall was 40 × 30 cm. We used 2 biological prostheses (40 × 20 cm and 30 × 20 cm) to close the abdominal wall. The patient was discharged on postoperative day 5 without complications. An abdominal magnetic resonance imaging scan showed complete integrity of the biological prostheses at 1 year after surgery. Conclusions: Transplant recipients have higher risks with use of synthetic prostheses because of being immunosuppressed, compared with other patients. Recent studies show that biological prostheses provided similar functional results without complications compared with synthetic prostheses. These prostheses are versatile and do not require any changes in immunosuppressive therapy. Therefore, they seem to be a better option than synthetic prostheses. In our opinion, biological prostheses are more safe, effective, and reliable than synthetic prostheses, especially for large incisional hernias in transplant recipients. We believe that further larger studies can support our opinion.

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