Ventral Hernia Repair After Bowel Surgery

Pinell-White, Ximena; Gruszynski, Mark A.; Losken, Albert

doi:10.1097/sap.0000000000000100

Cited by 14 publications

(3 citation statements)

References 6 publications

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“…In order to study the strength of adhesions, a model can be created by denuding an area on the abdominal wall and bowel. 66 – 68 Furthermore, as increasing numbers of biological meshes are used in the contaminated setting, 69 , 70 animal model with bacteria inoculated into the implant sites 71 – 73 or caecal puncture (peritonitis model) 74 has been developed to assess the tolerance of implants against infection. Both of these techniques could be incorporated into our model.…”

Section: Discussionmentioning

confidence: 99%

A clinically relevant in vivo model for the assessment of scaffold efficacy in abdominal wall reconstruction

et al. 2016

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An animal model that allows for assessment of the degree of stretching or contraction of the implant area and the in vivo degradation properties of biological meshes is required to evaluate their performance in vivo. Adult New Zealand rabbits underwent full thickness subtotal unilateral rectus abdominis muscle excision and were reconstructed with the non-biodegradable Peri-Guard®, Prolene® or biodegradable Surgisis® meshes. Following 8 weeks of recovery, the anterior abdominal wall tissue samples were collected for measurement of the implant dimensions. The Peri-Guard and Prolene meshes showed a slight and obvious shrinkage, respectively, whereas the Surgisis mesh showed stretching, resulting in hernia formation. Surgisis meshes showed in vivo biodegradation and increased collagen formation. This surgical rabbit model for abdominal wall defects is advantageous for evaluating the in vivo behaviour of surgical meshes. Implant area stretching and shrinkage were detected corresponding to mesh properties, and histological analysis and stereological methods supported these findings.

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Section: Discussionmentioning

confidence: 99%

A clinically relevant in vivo model for the assessment of scaffold efficacy in abdominal wall reconstruction

et al. 2016

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“…However, other surgeons have reported abdominal wall closure in the infected field as well. In a recent study of 82 patients with ventral hernia repaired predominantly with Alloderm and Strattice, 32 (39 %) had had concomitant intestinal surgery [68]. There was no difference in hernia recurrence (contaminated group—28 % vs. non‐contaminated group—34 %, p = 0.58), surgical site infections (contaminated—28 % vs. non‐contaminated—20 %, p = 0.40) or other complications when patients with and without concomitant bowel surgery were compared.…”

Section: Current Data On Biologic Grafts and Long‐term Follow‐upmentioning

confidence: 99%

Practical Approaches to Definitive Reconstruction of Complex Abdominal Wall Defects

Latifi

2015

World j. surg.

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With advances in abdominal surgery and the management of major trauma, complex abdominal wall defects have become the new surgical disease, and the need for abdominal wall reconstruction has increased dramatically. Subsequently, how to reconstruct these large defects has become a new surgical question. While most surgeons use native abdominal wall whenever possible, evidence suggests that synthetic or biologic mesh needs to be added to large ventral hernia repairs. One particular group of patients who exemplify "complex" are those with contaminated wounds, enterocutaneous fistulas, enteroatmospheric fistulas, and/or stoma(s), where synthetic mesh is to be avoided if at all possible. Most recently, biologic mesh has become the new standard in high-risk patients with contaminated and dirty-infected wounds. While biologic mesh is the most common tissue engineered used in this field of surgery, level I evidence is needed on its indication and long-term outcomes. Various techniques for reconstructing the abdominal wall have been described, however the long-term outcomes for most of these studies, are rarely reported. In this article, I outline current practical approaches to perioperative management and definitive abdominal reconstruction in patients with complex abdominal wall defects, with or without fistulas, as well as those who have lost abdominal domain.

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“…However, synthetic meshes can lead to various complications, such as infection, intestinal fistula, intestinal obstruction, discomfort and chronic pain[ 6 , 7 ]. Moreover, contamination is the relative contradiction to apply synthetic mesh, which would result in infection and repair failure[ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Porcine Small Intestinal Submucosa versus Polypropylene in Open Inguinal Hernia Repair: A Systematic Review and Meta-Analysis

et al. 2015

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BackgroundA systematic review and meta-analysis was performed in randomized controlled trials (RCTs) to compare porcine small intestinal submucosa (SIS) with polypropylene in open inguinal hernia repair.MethodElectronic databases MEDLINE, Embase, and the Cochrane Library were used to compare patient outcomes for the two groups via meta-analysis.ResultA total of 3 randomized controlled trials encompassing 200 patients were included in the meta-analysis. There was no significant difference in recurrence (P = 0.16), hematomas (P = 0.06), postoperative pain within 30 days (P = 0.45), or postoperative pain after 1 year (P = 0.12) between the 2 groups. The incidence of discomfort was significantly lower (P = 0.0006) in the SIS group. However, the SIS group experienced a significantly higher incidence of seroma (P = 0.03).ConclusionsCompared to polypropylene, using SIS in open inguinal hernia repair is associated with a lower incidence of discomfort and a higher incidence of seroma. However, well-designed larger RCT studies with a longer follow-up period are needed to confirm these findings.

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Ventral Hernia Repair After Bowel Surgery

Abstract: Biologic materials have made it such that ventral hernias can be safely repaired after bowel surgery without increased risk of complications.

Cited by 14 publications

References 6 publications

A clinically relevant in vivo model for the assessment of scaffold efficacy in abdominal wall reconstruction

A clinically relevant in vivo model for the assessment of scaffold efficacy in abdominal wall reconstruction

Practical Approaches to Definitive Reconstruction of Complex Abdominal Wall Defects

Comparison of Porcine Small Intestinal Submucosa versus Polypropylene in Open Inguinal Hernia Repair: A Systematic Review and Meta-Analysis

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