Soft Polypropylene Mesh, But Not Cadaveric Dermis, Significantly Improves Outcomes in Midline Hernia Repairs Using the Components Separation Technique

Ko, Jason H.; Salvay, David M.; Paul, Benjamin C.; Wang, Edward C.; Dumanian, Gregory A.

doi:10.1097/prs.0b013e3181b0380e

Cited by 77 publications

(42 citation statements)

References 64 publications

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“…Traditionally, synthetic mesh repair has been used in many patients and has demonstrated a reduction in recurrence compared with suture repair. [1][2][3][4][5] Although commonly used in the repair of ventral hernias, the use of synthetic mesh is considered contraindicated in contaminated cases primarily because of the increased risk for infection, prolonged hospitalization, and mesh removal. [6][7][8] Strattice Reconstructive Tissue Matrix (LifeCell Corporation; Branchburg, New Jersey) is a noncross-linked porcine-derived acellular dermal matrix (PADM) that, along with other acellular dermal matrices (ADMs), has demonstrated efficacy in the reinforcement of AWR.…”

mentioning

confidence: 99%

Critical Analysis of Strattice Performance in Complex Abdominal Wall Reconstruction: Intermediate–Risk Patients and Early Complications

Patel

Albino

Nahabedian

et al. 2013

International Surgery

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The purpose of this study was to analyze the performance of a porcine-derived acellular dermal matrix (Strattice Reconstructive Tissue Matrix) in patients at increased risk for perioperative complications. We reviewed medical records for patients with complex abdominal wall reconstruction (AWR) and Strattice underlay from 2007 to 2010. Intermediate-risk patients were defined as having multiple comorbidities without abdominal infection. Forty-one patients met the inclusion criteria (mean age, 60 years; mean body mass index, 35.5 kg/m2). Comorbidities included coronary artery disease (63.4%), diabetes mellitus (36.6%), and chronic obstructive pulmonary disease (17.1%). Fascial closure was achieved in 40 patients (97.6%). Average hospitalization was 6.4 days (range, 1–24 days). Complications included seroma (7.3%), wound dehiscence with Strattice exposure (4.9%), cellulitis (2.4%), and hematoma (2.4%). All patients achieved abdominal wall closure with no recurrent hernias or need for Strattice removal. Patients with multiple comorbidities at intermediate risk of postoperative complications can achieve successful, safe AWR with Strattice.

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confidence: 99%

Critical Analysis of Strattice Performance in Complex Abdominal Wall Reconstruction: Intermediate–Risk Patients and Early Complications

Patel

Albino

Nahabedian

et al. 2013

International Surgery

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“…The successful application of metronidazole in treating PI has been described before [15]. Similarly, elemental diet has been reported to alter the colonic microflora, thereby helping in the resolution of PI [16].…”

Section: Discussionmentioning

confidence: 95%

Extensive Pneumatosis Intestinalis in Association With Celiac Disease: A Case Report

Dayal¹

2011

J Med Cases

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Pneumatosis intestinalis (PI) is generally regarded as a worrying sign due to its relatively frequent association with serious conditions such as acute gastrointestinal necrosis. While PI can also be associated with a wide spectrum of benign conditions, its diagnosis as benign is usually accepted with the exclusion of gangrenous bowel, even in the absence of other clinical signs suggesting ischemia. We report a case of extensive PI in a patient with celiac disease and discuss its management and the role of diagnostic laparoscopy in this condition with emphasis on the different etiologies of PI.

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“…Differences between specific biologic mesh products are based on limited findings in the absence of rigorous outcome comparisons between these products. 18 Overall, the integration of biologic mesh with native tissue confers the advantage of resisting infection and decreasing the need of mesh explantation in a contaminated environment.…”

Section: Discussionmentioning

confidence: 99%

“…Ko et al compared recurrence and complication rates in incisional hernia repair with component separation and intraperitoneal underlay mesh reinforcement using soft mid-weight polypropylene (Prolene Soft Mesh and Proceed Surgical Mesh; Ethicon Inc., Blue Ash, OH, USA) (28 patients) and human acellular dermis (26 patients); they found a much higher recurrence rate among hernias repaired with human acellular dermis as compared to soft polypropylene (46% versus 11%, respectively; mean follow-up 17 months and 16 months, respectively). They also evaluated the recurrence rates among the two groups in patients without contaminated wounds and found that the recurrence rate was still significantly higher in repair with AlloDerm as compared to soft polypropylene (61% versus 12%, respectively), 18 suggesting that contamination alone does not account for the higher rate of recurrence. Diaz et al, in a study of 240 patients who underwent repair of a ventral hernia in a compromised field with human acellular dermal matrix, and Lin et al, in a study of 144 patients who underwent AWR with human acellular dermal matrix, reported recurrence rates of 17.1% and 27.1%, respectively.…”

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confidence: 99%

Biologic mesh for abdominal wall reconstruction

King¹,

Albino²,

Bhanot³

2014

CWCMR

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Background: Mesh reinforcement significantly decreases rates of recurrence following ventral hernia repair. Historically, biologic mesh was touted as superior in the setting of infection; however, selecting the appropriate mesh for a given clinical scenario is often a matter of debate. The purpose of this review is to highlight a number of the more commonly used biologic mesh products with a review of outcomes from the current literature. Methods: Outcomes following abdominal wall reconstruction using biologic mesh were reviewed for acellular cadaveric human dermis, cross-linked porcine dermis, non-cross-linked porcine dermis, porcine small intestine submucosa, acellular bovine pericardial, and acellular bovine dermal mesh. Studies with rigorous methods, adequate patient samples, and sufficient follow-up were selected for review. Results: Hernia recurrence rates following biologic mesh reinforcement vary widely. Porcine small intestine submucosa and bovine pericardium were associated with the lowest hernia recurrence rates. Porcine cross-linked dermal mesh products resulted in higher rates of adhesion formation and lower rates of tissue incorporation compared to non-cross-linked porcine mesh. Conclusion: Successful ventral hernia repair can be achieved with acceptable complications rates for each of the reviewed mesh products. Biologic meshes have an advantage over synthetic mesh in contaminated wounds but their use may not be cost-effective in all patient populations. Those with and/or at high risk for wound complications may also undergo repair with biologic mesh.

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Soft Polypropylene Mesh, But Not Cadaveric Dermis, Significantly Improves Outcomes in Midline Hernia Repairs Using the Components Separation Technique

Abstract: Soft polypropylene mesh, but not acellular dermis, demonstrates acceptably low complication and hernia recurrence rates when used as a reinforcement of the midline ventral hernia closure in conjunction with components separation.

Cited by 77 publications

References 64 publications

Critical Analysis of Strattice Performance in Complex Abdominal Wall Reconstruction: Intermediate–Risk Patients and Early Complications

Critical Analysis of Strattice Performance in Complex Abdominal Wall Reconstruction: Intermediate–Risk Patients and Early Complications

Extensive Pneumatosis Intestinalis in Association With Celiac Disease: A Case Report

Biologic mesh for abdominal wall reconstruction

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