scholarly journals Remodeling characteristics and collagen distribution in synthetic mesh materials explanted from human subjects after abdominal wall reconstruction: an analysis of remodeling characteristics by patient risk factors and surgical site classifications

2014 ◽  
Vol 28 (6) ◽  
pp. 1852-1865 ◽  
Author(s):  
Jaime A. Cavallo ◽  
Andres A. Roma ◽  
Mateusz S. Jasielec ◽  
Jenny Ousley ◽  
Jennifer Creamer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Wall ◽  
Human Subjects ◽  
Abdominal Wall Reconstruction ◽  
Synthetic Mesh ◽  
Patient Risk

Biologic mesh is non-inferior to synthetic mesh in CDC class 1 & 2 open abdominal wall reconstruction

2021 ◽  
Author(s):  
Jenny M. Shao ◽  
Sullivan A. Ayuso ◽  
Eva B. Deerenberg ◽  
Sharbel A. Elhage ◽  
Tanu Prasad ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Synthetic Mesh ◽  
Biologic Mesh ◽  
Class 1

scholarly journals P011 THE EARLY OUTCOMES OF ABDOMINAL WALL RECONSTRUCTION WITH POLYVINYLIDENE (PVDF) MESH IN THE INFECTED SETTING: A CASE-CONTROL SERIES

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Claudio Birolini ◽  
Eduardo Tanaka ◽  
Jocielle Miranda ◽  
Abel Murakami ◽  
Edivaldo Utiyama
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Synthetic Mesh ◽  
Tissue Response ◽  
Abdominal Wall Defects ◽  
Chronic Infections ◽  
Control Series ◽  
Elective Setting ◽  
Abdominal Operations ◽  
Low Incidence

Abstract Aim The use of synthetic mesh to repair infected defects of the abdominal wall remains controversial. PVDF mesh was introduced in 2002 as an alternative to polypropylene, with the advantages of improved biostability, lowered bending stiffness, and minimum tissue response. This study aimed to evaluate the short-term outcomes of using PVDF mesh to treat infected abdominal wall defects in the elective setting. Material and Methods A prospective clinical trial started in 2016 and designed to evaluate the short and mid-term outcomes of 38 patients submitted to abdominal wall reconstruction in the setting of active mesh infection and/or enteric fistulas (AI) when compared to a group of 38 patients submitted to clean ventral hernia repairs (CC). Patients were submitted to single-staged repairs, using onlay PVDF mesh reinforcement to treat their defects. Results Groups had comparable demographic characteristics. The AI group had more previous abdominal operations and a longer operative and anesthesia time. At 30-days, surgical site occurrences were observed in 18 (47.4%) AI vs. 17 (44.7%) CC; surgical site infection occurred in 4 (10.4%) AI vs. 6 (15.8%) CC, and a higher number of procedural interventions were required in the CC group, 15.8% AI vs. 28.9% CC. At 6-months follow-up, no chronic infections or hernia recurrences were observed in both groups. Conclusions The use of PVDF mesh in the infected setting presented very favorable results with a low incidence of wound infection.

Analysis of Risk Factors, Morbidity, and Cost Associated with Respiratory Complications following Abdominal Wall Reconstruction

2014 ◽  
Vol 133 (1) ◽  
pp. 147-156 ◽  
Author(s):  
John P. Fischer ◽  
Ari M. Wes ◽  
Jason D. Wink ◽  
Jonas A. Nelson ◽  
Benjamin M. Braslow ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Respiratory Complications

Value Improvement and Resource Utilization in Complex Abdominal Wall Reconstruction

2019 ◽  
Vol 85 (10) ◽  
pp. 1113-1117 ◽  
Author(s):  
Cory K. Mayfield ◽  
Daniel J. Gould ◽  
Alex Wong ◽  
Ketan M. Patel ◽  
Joseph Carey
Keyword(s):  
Abdominal Wall ◽  
Recurrence Rate ◽  
Abdominal Wall Reconstruction ◽  
Synthetic Mesh ◽  
Low Risk ◽  
Biologic Mesh ◽  
Institutional Pressures ◽  
Recurrence Rates ◽  
Significant Difference ◽  
Risk Patients

Although recommendations help guide surgeons’ mesh choice in abdominal wall reconstruction (AWR), financial and institutional pressures may play a bigger role. Standardization of an AWR algorithm may help reduce costs and change mesh preferences. We performed a retrospective review of high- and low-risk patients who underwent inpatient AWR between 2014 and 2016. High risk was defined as immunosuppression and/or history of infection/contamination. Patients were stratified by the type of mesh as biologic/biosynthetic or synthetic. These cohorts were analyzed for outcome, complications, and cost. One hundred twelve patients underwent complex AWR. The recurrence rate at two years was not statistically different between high- and low-risk cohorts. No significant difference was found in the recurrence rate between biologic and synthetic meshes when comparing both high- and low-risk cohorts. The average cost of biologic mesh was $9,414.80 versus $524.60 for synthetic. The estimated cost saved when using synthetic mesh for low-risk patients was $295,391.20. In conclusion, recurrence rates for complex AWR seem to be unrelated to mesh selection. There seems to be an excess use of biologic mesh in low-risk patients, adding significant cost. Implementing a critical process to evaluate indications for biologic mesh use could decrease costs without impacting the quality of care, thus improving the overall value of AWR.

Biological Mesh in Contaminated Fields—Overuse without Data: A Systematic Review of Their Use in Abdominal Wall Reconstruction

2014 ◽  
Vol 80 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Wirt Cross ◽  
Ajay Kumar ◽  
Gopal Chandru Kowdley
Keyword(s):  
Systematic Review ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
English Language ◽  
Human Subjects ◽  
Abdominal Wall Reconstruction ◽  
Case Series ◽  
Biological Mesh ◽  
End Points ◽  
Scientific Papers

Ventral hernia repair in contaminated fields is a significant problem for surgeons. We performed a systematic review regarding the use of biological mesh in contaminated fields for abdominal wall reconstruction. The primary end points were recurrence and infection of the hernia repair. An independent search of scientific papers in the English language was performed by three reviewers. Articles were chosen based on reference to ventral hernias, their use in infected fields, and in human subjects. Papers were scored using the Methodological Index for Non-Randomized Studies and those with a score of 8 or more were combined to evaluate the end points. A total of 16 studies from six different mesh products met our criteria. These papers comprised 554 patients with an overall infection rate of 24 per cent and a recurrence rate of 20 per cent. The largest study used 116 patients. All papers were case series. Overall the data for use of biological mesh products in contaminated fields are limited. Further controlled studies are needed to address this important and clinically relevant question. Caution should be used when using biological mesh products in infected fields because there is a paucity of controlled data and none have U.S. Food and Drug Administration approval for use in infected fields.

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