Reinforced Biologic Mesh Reduces Postoperative Complications Compared to Biologic Mesh after Ventral Hernia Repair

Abstract

Background: The use of biologic mesh to reinforce the abdominal wall in ventral hernia repair has been proposed as a viable alternative to synthetic mesh, particularly for high-risk patients and in contaminated settings. However, a comparison of clinical outcomes between the currently available biologic mesh types has yet to be performed. Methods: We performed a retrospective analysis of 141 patients who had undergone ventral hernia repair with biologic mesh, including noncross-linked porcine ADM (NC-PADM) (n = 51), cross-linked porcine ADM (C-PADM) (n = 17), reinforced biologic ovine rumen (RBOR) (n = 36), and bovine ADM (BADM) (n = 37) at the Stanford University Medical Center between 2002 and 2020. Postoperative donor site complications and rates of hernia recurrence were compared between patients with different biologic mesh types. Results: Abdominal complications occurred in 47.1% of patients with NC-PADM, 52.9% of patients with C-PADM, 16.7% of patients with RBOR, and 43.2% of patients with BADM (P = 0.015). Relative risk for overall complications was higher in patients who had received NC-PADM (RR = 2.64, P = 0.0182), C-PADM (RR = 3.19, P = 0.0127), and BADM (RR = 2.11, P = 0.0773) compared with those who had received RBOR. Furthermore, relative risk for hernia recurrence was also higher in all other mesh types compared with RBOR. Conclusion: Our data indicate that RBOR decreases abdominal complications and recurrence rates after ventral hernia repair compared with NC-PADM, C-PADM, and BADM.

Year-Over-Year Ventral Hernia Recurrence Rates and Risk Factors

“…We found no difference in recurrence rates based on mesh location, which is consistent with recent studies . Furthermore, high-quality data are scarce regarding the superiority of any specific mesh type . In our study, we found that biologic mesh and resorbable synthetic mesh were associated with an increase in risk of recurrence compared to permanent synthetic mesh.…”

Potential possibilities of bioengineering technologies and cellular implantation in hernioendoprosthetics (review article)

“…Тем не менее большое число авторов сходятся во мнении, что использование биологических сеток гарантированно приводит к более высокому проценту осложнений в послеоперационном периоде [37]. Авторы указывают образование сером, нагноение парапротезной области, инфекционные осложнения со стороны раны, рецидивы грыж [38,39] [42].…”

Comparing the Outcomes and Complication Rates of Biologic vs Synthetic Meshes in Implant-Based Breast Reconstruction

“…10,14 The most popular biologic mesh substrates include human, bovine, or porcine tissues, where various processing techniques preserve different cellular and extracellular materials to encourage host cell integration. 15 Synthetic meshes are generally made of manufactured polymers, such as polypropylene, polyester, or expanded polytetrafluorethylene, which may be combined with other materials to make composite matrices with varied physical properties. 14 These synthetic sheets of material can be knitted or woven, be absorbable or nonabsorbable, and offer a low-cost alternative to biologic matrices while also allowing for more control over the flexibility and tensile strength of the material.…”

“…Biologic mesh, or acellular dermal matrix (ADM), is composed of animal or human tissue that has been stripped of its antigenic cells and processed into a matrix of collagen and elastin 10,14 . The most popular biologic mesh substrates include human, bovine, or porcine tissues, where various processing techniques preserve different cellular and extracellular materials to encourage host cell integration 15 . Synthetic meshes are generally made of manufactured polymers, such as polypropylene, polyester, or expanded polytetrafluorethylene, which may be combined with other materials to make composite matrices with varied physical properties 14 .…”