Repair of large abdominal incisional hernia by reconstructing the midline and use of an onlay of biological material

Tuveri, Massimiliano; Tuveri, A; Nicolo, Enrico

doi:10.1016/j.amjsurg.2010.06.005

Cited by 16 publications

(15 citation statements)

References 31 publications

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“…1 Inorganic materials are passive, rigid, and adynamic, and they restore the structure but not the function of the abdominal wall. 2 Moreover, inorganic materials are associated with foreign body complications. 2 Half of the patients who develop a recurrence have an infection, and transplant recipients have higher risks of the use of synthetic prostheses because of being immunosuppressed.…”

Section: Umit Ozcelik Et Al/experimental and Clinical Transplantationmentioning

confidence: 99%

“…2 Moreover, inorganic materials are associated with foreign body complications. 2 Half of the patients who develop a recurrence have an infection, and transplant recipients have higher risks of the use of synthetic prostheses because of being immunosuppressed. 1,9 Recent studies showed that biological prostheses provided similar functional results without complications compared with synthetic prostheses.…”

Section: Umit Ozcelik Et Al/experimental and Clinical Transplantationmentioning

confidence: 99%

“…[1][2][3] Incisional hernias develop in 10% patients who subsequently develop a wound infection. 1 The risks of fascial dehiscence, wound infection, and incisional hernias are higher in organ recipients than they are in other patients.…”

Section: Introductionmentioning

confidence: 99%

“…1,3 The main principle of incisional hernia repair is to restore the anatomic and physiologic integrity of the abdominal wall. 2 Fascial defects with diameter < 6 cm can be repaired primarily, but 30% to 50% defects > 6 cm recur after primary closure. 2 Several types of prosthetic mesh currently are available for hernia repair.…”

Section: Introductionmentioning

confidence: 99%

“…2 Fascial defects with diameter < 6 cm can be repaired primarily, but 30% to 50% defects > 6 cm recur after primary closure. 2 Several types of prosthetic mesh currently are available for hernia repair. 6 Although permanent mesh prostheses are considered the best treatment for minimizing hernia recurrence, they have been associated with a high risk of complications due to their nonabsorbable characteristics such as erosion into the abdominal viscera, protrusion, extrusion, adhesion, infection, and bowel fistulae that can lead to more complex and costly surgery.…”

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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Section: Umit Ozcelik Et Al/experimental and Clinical Transplantationmentioning

confidence: 99%