SP7.2.4 Evaluation of Non-crosslinked Acellular Porcine Dermal Mesh – A Single Centre Experience

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Rama Karri ◽  
Amaar Aamery ◽  
Deepak Singh-Ranger
Keyword(s):  
Chronic Pain ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Parastomal Hernia ◽  
Abdominal Wall Reconstruction ◽  
Hernia Recurrence ◽  
Biological Mesh ◽  
Ease Of Use ◽  
Secondary Outcome ◽  
Retrospective Case

Abstract Aims We report our experience with a cellular porcine dermal non-crosslinked biological mesh (EGIS®). We conducted a review of indications and outcomes of patients requiring the mesh for incisional hernia/complex abdominal wall reconstruction with component separation, parastomal hernia repairs and ELAPE. Patients were followed for a minimum of 6 and assessed for recurrence, seroma formation and chronic pain. Secondary outcome was the assessment of ease of use by the Surgeon – suturing and pliability. Method A retrospective case notes review of patients requiring biological mesh (EGIS®) from 2016 to present. A qualitative survey about ease of use of EGIS® for operations studied was sent to all Consultant Surgeons. Results EGIS® mesh was used in 38 patients: 23 Hernia repairs – 13 Incisional, 8 Parastomal, 2 Paraumbilical; 12 Pelvic floor repairs after ELAPE; and 3 abdominal wall reconstructions. Hernia recurrence occurred in 12 (32%), seroma 7 (18%) and chronic pain 7 (18%). The highest complications occurred in the incisional and parastomal hernia groups. Incisional hernia: recurrence in 5 (38%), seroma in 5 (38%) and chronic pain in 3 (23%). Parastomal hernia: recurrence in 3 (38%), chronic pain 2 (25%), seroma 1 (13%). Consultants scored the mesh 4.3 to 4.5 out of 10 for pliability, ease of use and suturing. Conclusion Biological mesh is used to reinforce hernia repairs in contaminated or potentially contaminated fields. Non-crosslinked meshes are preferred for their greater cellular infiltration from host tissue with improved integration. Our experience with this mesh shows a high complication rate and requires re-evaluation.

scholarly journals Performance of biological mesh materials in abdominal wall reconstruction: study protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024091 ◽  
Author(s):  
David A Carver ◽  
Andrew W Kirkpatrick ◽  
Tammy L Eberle ◽  
Chad G Ball
Keyword(s):  
Informed Consent ◽  
Randomised Controlled Trial ◽  
Abdominal Wall ◽  
Controlled Trial ◽  
Abdominal Wall Reconstruction ◽  
Hernia Recurrence ◽  
Biological Mesh ◽  
Common Source ◽  
Porcine Dermis ◽  
Randomised Controlled

IntroductionAbdominal wall hernias are a common source of morbidity and mortality. The use of biological mesh has become an important adjunct in successful abdominal wall reconstruction. There are a variety of biological mesh products available; however, there is limited evidence supporting the use of one type over another. This study aims to compare the performance (eg, the rate of hernia recurrence) of either a crosslinked biological mesh product or a non-crosslinked product in patients undergoing abdominal wall reconstruction.Methods and analysisThis is a single-centre, dual arm randomised controlled trial. Patients requiring abdominal wall reconstruction will be assessed for eligibility. Eligible patients will then undergo an informed consent process following by randomisation to either (1) crosslinked porcine dermis mesh (Permacol); or (2) non-crosslinked porcine dermis mesh (Strattice). These groups will be compared for the rate of hernia recurrence at 1 and 2 years as well as the rate of postoperative complications (eg, surgical site infections).Ethics and disseminationThis study has been approved by the institution’s research ethics board and registered with clinicaltrials.gov. All eligible participants will provide informed consent prior to randomization. The results of this study may help guide the choice of biologic mesh for this population. The results of this study will be published in peer-reviewed journals as well as national and international conferences.Trial registration numberNCT02703662.

scholarly journals A randomized controlled study to compare the efficacy of hughes abdominal repair with conventional abdominal closure-to reduce the incidence of incisional hernias in Indian population

2017 ◽  
Vol 4 (7) ◽  
pp. 2291
Author(s):  
Rajasekaran C. ◽  
Vijaykumar K. ◽  
Arulkumaran M. ◽  
Meera S. S.
Keyword(s):  
Randomized Controlled Trial ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Midline Laparotomy ◽  
Incisional Hernias ◽  
Abdominal Closure ◽  
Randomized Controlled ◽  
Abdominal Repair

Background: Incisional hernia forms the most common delayed morbidity following midline laparotomy surgeries- causing mental trauma to the patient impairing their quality of life and scars the name and fame of the surgeon. So, the need for possible attributes on surgeon’s aspect to prevent the incisional hernia is the need of the hour. We planned a randomized controlled trial to compare two different abdominal closure techniques to reduce the incidence of Incisional hernia following midline laparotomy incisions. We advocated Hughes abdominal repair which includes a series of two horizontal and two vertical mattresses within single suture whereby the tension load of suture is distributed both along and across the suture line.Methods: 1:1 Randomized controlled trial in which the patient is blinded and obviously operating surgeon is non-blinded. Evaluating examiner and radiologist are blinded.100 patients who underwent emergency and elective midline laparotomies were enrolled in the study and intra-operatively randomized into two groups in 1:1 pattern. Ethical clearance obtained from the Institutional ethical committee. The primary outcome measure is the incidence of burst abdomen at the end of 15 days by the evaluating surgeon (non-operated surgeon who is blinded). The secondary outcome is the incidence of incisional hernia at the end of one year-evaluated by detailed clinical examination with radiological proof using CT abdomen.Results: The incidence of incisional hernia is significantly low in Hughes abdominal repair than conventional abdominal closure.Conclusions: Hughes abdominal wall closure is superior to conventional closure in both emergency and elective laparotomy cases, in prevention of wound dehiscence and Incisional hernias later. Present study encourages us that Hughes abdominal wall repair is comparable to mesh repairs. This study needs to be continued further to a vast sample size to perfectly assess the statistical significance.

scholarly journals Abdominal Wall Reconstruction with a Free Fibula Flap after Internal Extended Hemipelvectomy

2020 ◽  
Vol 53 (01) ◽  
pp. 131-134
Author(s):  
Pedro C. Cavadas ◽  
Daniela Téllez-Palacios
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Malignant Tumors ◽  
Abdominal Wall Reconstruction ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Free Fibula Flap ◽  
Fibula Flap ◽  
Free Fibula

AbstractMajor pelvic resections for malignant tumors are infrequent and have significant morbidity and mortality, for instance, incisional hernias are postoperative complications uncommonly reported probably because most cases are overshadowed by more serious complications. Reconstruction depends on the extent of the resection and overall prognosis of the patient. A case of a late complex hypogastric and femoral incisional hernia after extended hemipelvectomy for recurrent osteosarcoma treated with distal abdominal wall fixation into a free fibula flap is reported.

Abdominal wall reconstruction for large incisional hernia restores expiratory lung function

Surgery ◽  
2017 ◽  
Vol 161 (2) ◽  
pp. 517-524 ◽  
Author(s):  
Kristian K. Jensen ◽  
Vibeke Backer ◽  
Lars N. Jorgensen
Keyword(s):  
Lung Function ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Large Incisional Hernia

scholarly journals EP.TH.108A Descriptive Case Series of Incisional Hernia Repair Using Dual Mesh Technique

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Chloe Theodorou ◽  
Zia Moinuddin ◽  
David Van Dellen
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Surgical Techniques ◽  
Case Series ◽  
Incisional Hernia Repair ◽  
Fistula Formation ◽  
Mesh Technique ◽  
Dual Mesh

Abstract Aims Incisional hernias are a common complication after surgery that cause significant patient morbidity. Symptomatic patients are offered repair but many surgical techniques exist, with abdominal wall reconstruction becoming preferable for large complex defects. This paper describes our experience of abdominal wall reconstruction using a dual mesh technique. Method 22 patients underwent incisional hernia repair between March 2019 and September 2020. All patients received dual mesh, placed in retrorectus or transversalis fascial/retromuscular space. Absorbable BIO-A GORE mesh was used with a polypropylene mesh above. All patients were followed up to assess for complications and recurrence. Results No patients experienced fistula formation, long-term pain or obstructive symptoms. We report one true hernia recurrence (4.5%) and one case of infected mesh (4.5%), these both await further treatment. One patient had a proven wound infection which resolved with conservative treatment. 4 patients (18.2%) experienced seromas, 3 of these resolved spontaneously, one requiring image-guided drainage. Conclusion Incisional hernia repair using combination polypropylene and bio-absorbable mesh provides a safe and effective repair with low recurrence and incidence of surgical site occurrences in the short term. Longer follow up and further studies are needed to evaluate this mesh technique to support ongoing use of absorbable meshes in complex hernia repair.

scholarly journals Incisional hernia repair in women of childbearing age: A nationwide propensity-score matched study

2019 ◽  
Vol 109 (4) ◽  
pp. 295-300
Author(s):  
E. Oma ◽  
K. K. Jensen ◽  
L. N. Jorgensen ◽  
T. Bisgaard
Keyword(s):  
Chronic Pain ◽  
Propensity Score ◽  
Confidence Interval ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Subsequent Pregnancy ◽  
Secondary Outcome ◽  
Women Of Childbearing Age ◽  
Childbearing Age

Background & Aims: Although incisional hernia repair in women of childbearing age is not rare, hernia disease in this group of patients is sparsely documented. The aim of this study was to examine long-term clinical results after incisional hernia repair in women of childbearing age. Material and methods: This nationwide cohort study examined incisional hernia repair from 2007 to 2013 in women of childbearing age, registered prospectively in the Danish Ventral Hernia Database. All women with a subsequent pregnancy were included, and a 1:3 propensity-score matched group of women with an incisional hernia repair without a subsequent pregnancy. A prospective follow-up was conducted, including a validated questionnaire. The primary outcome was recurrence, and the secondary outcome was chronic pain from the operated site. Results: In total, 124 (70.5%) women responded, 47 and 77 women with and without a subsequent pregnancy, respectively. The 5-year cumulative incidence of recurrence was 41.0% (95% confidence interval 32.0%–49.9%). After adjustment for potential confounders, subsequent pregnancy was independently associated with recurrence (hazard ratio 1.83, 95% confidence interval 1.02–3.29, p = 0.044). Twenty-six (21.0%) women reported chronic pain (moderate, n = 21; severe, n = 5) with no difference between women with and without a subsequent pregnancy. Hernia recurrence, higher body mass index, and smoking were associated with chronic pain. Conclusion: Pregnancy following incisional hernia repair was associated with an increased risk of recurrence, but not with chronic pain.

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