Improved Outcomes in the Management of High‐Risk Incisional Hernias Utilizing Biological Mesh and Soft‐Tissue Reconstruction: A Single Center Experience

Skipworth, James; Vyas, Soumil; Uppal, Lauren; Floyd, David; Shankar, Aparna

doi:10.1007/s00268-013-2442-6

Cited by 21 publications

(20 citation statements)

References 58 publications

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“…Sixty-five articles described LOD in the context of ventral hernia patients, 9 articles described LOD caused by giant inguinal hernia, and 3 articles described giant diaphragmatic hernia. Sixty-seven articles were from the primary literature, comprising 44 case series, 17 case reports, 4 retrospective database analyses [ 18 , 33 – 35 ], and 2 retrospective interventional studies [ 36 ] [ 30 ]. Ten articles were from the secondary literature comprising seven editorials, two systematic reviews [ 20 , 37 ] and one consensus questionnaire [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

Parker

Halligan²,

Blackburn

et al. 2018

World j. surg.

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Large ventral hernias are a significant surgical challenge. "Loss of domain" (LOD) expresses the relationship between hernia and abdominal volume, and is used to predict operative difficulty and success. This systematic review assessed whether different definitions of LOD are used in the literature. The PubMed database was searched for articles reporting large hernia repairs that explicitly described LOD. Two reviewers screened citations and extracted data from selected articles, focusing on the definitions used for LOD, study demographics, study design, and reporting surgical specialty. One hundred and seven articles were identified, 93 full-texts examined, and 77 were included in the systematic review. Sixty-seven articles were from the primary literature, and 10 articles were from the secondary literature. Twenty-eight articles (36%) gave a written definition for loss of domain. These varied and divided into six broad groupings; four described the loss of the right of domain, six described abdominal strap muscle contraction, five described the "second abdomen", five describing large irreducible hernias. Six gave miscellaneous definitions. Two articles gave multiple definitions. Twenty articles (26%) gave volumetric definitions; eight used the Tanaka method [hernia sac volume (HSV)/abdominal cavity volume] and five used the Sabbagh method [(HSV)/total peritoneal volume]. The definitions used for loss of domain were not dependent on the reporting specialty. Our systematic review revealed that multiple definitions of loss of domain are being used. These vary and are not interchangeable. Expert consensus on this matter is necessary to standardise this important concept for hernia surgeons.

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Section: Resultsmentioning

confidence: 99%

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

Parker

Halligan²,

Blackburn

et al. 2018

World j. surg.

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“…Biologic materials-based meshes (BIOMESH) have recently emerged as a useful option to repair VH in high-risk patients; these meshes in fact, carry a lower risk of infection and degrade in septic fields thus avoiding the necessity of removal [ 3 , 10 ]. Piazzese et al in 2004 demonstrated no differences in terms of wound complications and VH recurrence in liver-transplanted patients undergoing incisional hernia repair comparing synthetic mesh with biological mesh [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Post-incisional ventral hernia repair in patients undergoing chemotherapy: improving outcomes with biological mesh

et al. 2016

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BackgroundPatients requiring ventral hernia (VH) repair during perioperative chemotherapy have a higher risk for post-operative complications. The aim of the study was to perform a case-controlled analysis in patients undergoing chemotherapy who underwent VH repair using biological mesh or synthetic mesh.MethodsFrom January 2013 to December 2015, 32 patients, within 8 weeks from chemotherapy administration, were treated electively for VH repair using a biological mesh (BIOMESH). A control group (CG) receiving chemotherapy within the same time interval and treated with synthetic meshes was selected. There were no differences regarding sex, age, American Society of Anesthesiologists (ASA) score III, BMI, and size of the defect. Morbidity, type of complications, and recurrence rate were investigated and compared between the two groups.ResultsIn the BIOMESH group, eight patients (25 %) experienced complications. Wound dehiscence occurred in four (12.5 %) patients and was treated conservatively. Only three small seromas not requiring treatment were observed. The CG presented a higher mean Clavien-Dindo complication grade (1.94 ± 0.44 vs 1.63 ± 0.52; p = 0.13) and a higher incidence of wound dehiscence (n = 9/32, 28.1 % vs n = 4/32, 12.5 %; p = 0.11). Five patients developed seroma treated by wound drainage. One patient experienced an intra-abdominal collection treated by percutaneous drainage. At the univariate and multivariate analysis use of traditional mesh, BMI and the ASA III were predictive factors of post-operative complications. Two patients (6.3 %) developed a VH recurrence only in the CG.ConclusionsBiological meshes could be considered a valid option to improve post-operative short-term outcomes in selected high-risk patients undergoing chemotherapy treated for VH repair.

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“…Among them, reinforcement with a prosthesis is favorable [1] , and the Rives–Stoppa technique is thought to be the most standard open surgical procedure [2–4] The component separation technique is another effective procedure. Although it is insufficient without a prosthesis [5] , it may be very effective with the use of a prosthesis [6] . Finally, laparoscopic hernioplasty has also been developed and its use is increasing [7] .…”

Section: Introductionmentioning

confidence: 99%

“…Candidates for incisional hernioplasty are usually patients with a high body mass index [3,4] and nonelderly patients [5,8] . Elderly patients with a small body size may also develop incisional hernias; however, most elderly patients with a thin abdominal wall do not undergo repair; instead, their hernia is simply observed.…”

Section: Introductionmentioning

confidence: 99%

Transitional mesh repair for large incisional hernia in the elderly

Kawaguchi

Ueno

Takahashi

et al. 2015

International Journal of Surgery Case Reports

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HighlightsLarge incisional hernias are difficult to repair, especially in elderly patients with thin abdominal walls.For an incisional hernia with thin destructed abdominal wall, combined onlay and underlay incisional hernia repair using one prosthesis was performed.The abdominal wall at the transitional zone is shifted to the rectus abdominis and the anterior sheath, in order to cover the transitional zone with other abdominal layers.We report a transitional mesh repair for a large incisional hernia in an elderly patient.

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Improved Outcomes in the Management of High‐Risk Incisional Hernias Utilizing Biological Mesh and Soft‐Tissue Reconstruction: A Single Center Experience

Cited by 21 publications

References 58 publications

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

Post-incisional ventral hernia repair in patients undergoing chemotherapy: improving outcomes with biological mesh

Transitional mesh repair for large incisional hernia in the elderly

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