Absorbable Polyglactin vs. Non-Cross-linked Porcine Biological Mesh for the Surgical Treatment of Infected Incisional Hernia

Renard, Yohann; Mestier, Louis de; Henriques, Julie; Boissieu, Paul de; Mestier, Philippe de; Fingerhut, Abe; Palot, J. P.; Kianmanesh, Réza

doi:10.1007/s11605-018-04095-8

Cited by 22 publications

(18 citation statements)

References 44 publications

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“…The expert consensus panel involved in the review of these guidelines recommends that polyglactin 910 mesh in a single, double or quadruple layer can be safely sutured to the edges of the fascia prior to skin and subcutaneous fat closure without risk of intestinal fistulation [ 614 , 615 ]. Polyglactin mesh may also serve as a framework for granulation tissue formation to prepare the wound for STSG.…”

Section: Introductionmentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

et al. 2021

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Aim There is a requirement for an expansive and up to date review of the management of emergency colorectal conditions seen in adults. The primary objective is to provide detailed evidence‐based guidelines for the target audience of general and colorectal surgeons who are responsible for an adult population and who practise in Great Britain and Ireland. Methods Surgeons who are elected members of the Association of Coloproctology of Great Britain and Ireland Emergency Surgery Subcommittee were invited to contribute various sections to the guidelines. They were directed to produce a pathology‐based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. Each author was asked to provide a set of recommendations which were evidence‐based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after two votes were included in the guidelines. Results All aspects of care (excluding abdominal trauma) for emergency colorectal conditions have been included along with 122 recommendations for management. Conclusion These guidelines provide an up to date and evidence‐based summary of the current surgical knowledge in the management of emergency colorectal conditions and should serve as practical text for clinicians managing colorectal conditions in the emergency setting.

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Section: Introductionmentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

et al. 2021

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“…According to studies, the proportion of recurrent hernias at 3 years after being masked in a contaminated environment (grade III of the VHWG) treated according to the recommended technique reaches 75%. 26 …”

Section: Discussionmentioning

confidence: 99%

Slowly absorbable mesh versus standard care in the management of contaminated midline incisional hernia (COMpACT-BIO): a multicentre randomised controlled phase III trial including a health economic evaluation

Passot

Margier²,

Kefleyesus

et al. 2022

BMJ Open

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IntroductionIncisional hernia (IH) is the most frequent mid-term and long-term complication after midline laparotomy. The current standard treatment includes repair using a mesh. In a contaminated field, the use of a non-absorbable mesh increases the risk of surgical site infection and the costs. Slowly absorbable meshes are safe in contaminated fields, but no data have been reported regarding their long-term recurrence rate. COMpACT-BIO is a multicentre prospective randomised controlled phase III trial designed to compare the 3-year recurrence rate in patients undergoing contaminated IH repair with either a slowly absorbable mesh or standard care.MethodsIn patients undergoing midline IH repair in a contaminated surgical field (grade III of the modified Ventral Hernia Working Group classification), the COMpACT-BIO study compares the use of a slowly absorbable mesh with that of conventional care according to standardised surgical procedures (primary closure, non-absorbable synthetic mesh or biologic mesh, at the discretion of the surgeon). Randomisation is done during surgery before closure the fascia with an allocation ratio of 1:1. The choice of the slowly absorbable mesh is left to the criteria of each centre. The primary endpoint is the proportion of patients with scan-confirmed IH recurrence within 3 years after repair.Ethics/disseminationThis trial is conducted in compliance with international standards for research practice and reporting. Written informed consent will be obtained from patients prior to inclusion. All data were identified and anonymised prior to analysis. The protocol has been approved by an Institutional Review Board (2020-A0823-36/SI:20.07.03.66831), and will be conducted in compliance with the CONSORT (Consolidated Standards of Reporting Trials) statement. Results will be submitted for publication in peer-reviewed medical journals and presented to patients and healthcare professionals.Protocol versionVersion 2—13 October 2020.Trial registration numberNCT04597840.

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“…Primary VH close to the midline with its center above the umbilicus Incisional hernia VH that developed after surgical trauma to the abdominal wall, including recurrences after repair of primary VHs infective complications compared to biologic and synthetic mesh in clean-contaminated and contaminated surgery, 23 as well as high recurrence rates. 24 Biologic meshes provide a collagen based extracellular matrix scaffold to promote fibroblast collagen deposition, cellular repopulation, and neovascularization. 6 Two types exist: cross-linked and non-crosslinked, with the former being more durable.…”

Section: Epigastric Herniamentioning

confidence: 99%

“…However, this has not been borne out in practice: biosynthetic mesh is associated with increased infective complications compared to biologic and synthetic mesh in clean-contaminated and contaminated surgery, 23 as well as high recurrence rates. 24 …”

Section: Mesh Selectionmentioning

confidence: 99%

An Evaluation of the Evidence Guiding Adult Midline Ventral Hernia Repair

Sagar

Tapuria

2022

Surg J (N Y)

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Purpose: Several guidelines have been published in recent years to guide the clinician in ventral hernia repair. This review distils this advice, critically assesses their evidence base, and proposes avenues for future study. Methods: A PUBMED search identified four guidelines addressing midline ventral hernia repair published by major surgical societies between 2016 and 2020. The studies used to inform the advice have been critically appraised, including 20 systematic reviews/meta-analyses, 10 randomized controlled trials, 32 cohort studies, and 14 case series. Results: Despite a lack of randomized controlled trials, case heterogeneity, and variation in outcome reporting, key themes have emerged.Preoperative computed tomography scan assesses defect size, loss of domain, and the likely need for component separation. Prehabilitation, frailty assessment, and risk stratification are beneficial in complex cases. Minimally invasive component separation techniques, Botox injection, and progressive pneumoperitoneum represent novel techniques to promote closure of large fascial defects.Rives-Stoppa sublay mesh repair has become the “gold” standard for open and minimally invasive repairs. Laparoscopic repair promotes early return to functional status. The enhanced-view totally extraperitoneal approach facilitates laparoscopic sublay mesh placement, avoiding mesh contact with viscera. Robotic techniques continue to evolve, although the evidence at present remains immature.Synthetic mesh is recommended for use in clean and clean-contaminated cases. However, optimism regarding the use of biologic and biosynthetic meshes in the contaminated setting has waned. Conclusions: Surgical techniques in ventral hernia repair have advanced in recent years. High-quality data has struggled to keep pace; rigorous clinical trials are required to support the surgical innovation.

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Absorbable Polyglactin vs. Non-Cross-linked Porcine Biological Mesh for the Surgical Treatment of Infected Incisional Hernia

Cited by 22 publications

References 44 publications

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

Slowly absorbable mesh versus standard care in the management of contaminated midline incisional hernia (COMpACT-BIO): a multicentre randomised controlled phase III trial including a health economic evaluation

An Evaluation of the Evidence Guiding Adult Midline Ventral Hernia Repair

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