Outcome of Abdominal Wall Hernia Repair with Biologic Mesh: Permacol™ versus Strattice™

The use of biologic mesh in abdominal wall operations has gained popularity despite a paucity of outcome data. Numerous biologic products are available with virtually no clinical comparison studies. A retrospective study was conducted to compare patients who underwent abdominal wall hernia repair with Permacol™ (crosslinked porcine dermis) and Strattice™ (noncrosslinked porcine dermis). Of 270 reviewed patients, 195 were implanted with Permacol™ and 75 with Strattice™. Ventral hernia repairs comprised the majority (85% for Permacol, 97% for Strattice™). Postoperative infection rate was lower in the Strattice™ group (5 vs 21%, P < 0.01). In the Permacol™ group only, the overall complication rates were significantly higher in patients with infected versus clean wounds (55 vs 35%, P < 0.05) and in obese patients (body mass index 40 kg/m2 or greater [57 vs 34%], P < 0.01). Short-term complication and recurrence rates were higher when mesh was used as a fascial bridge: 51 versus 28 per cent for Permacol™, 58 versus 20 per cent for Strattice™. The hernia recurrence was similar in both groups. In this review of patients undergoing abdominal hernia repair with biologic mesh, Strattice™ mesh was associated with a lower short-term complication rate compared with Permacol™, but the hernia recurrence rate was similar.

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Outcome of Abdominal Wall Hernia Repair with Permacol™ Biologic Mesh

The American Surgeon ◽

10.1177/000313481307901007 ◽

2013 ◽

Vol 79 (10) ◽

pp. 992-996 ◽

Cited By ~ 10

Author(s):

Amy W. Cheng ◽

Maher A. Abbas ◽

Talar Tejirian

Keyword(s):

Hernia Repair ◽

Abdominal Wall ◽

Complication Rate ◽

Abdominal Wall Hernia ◽

Outcome Data ◽

Biologic Mesh ◽

Abdominal Hernia ◽

Morbidly Obese ◽

Ventral Incisional Hernia ◽

Abdominal Wall Hernia Repair

The use of biologic mesh in abdominal wall operations has gained popularity despite a paucity of outcome data. We aimed to review the experience of a large healthcare organization with Permacol™. A retrospective study was conducted of patients who underwent abdominal hernia repair with Permacol™ in 14 Southern California hospitals. One hundred ninety-five patients were analyzed over a 4-year period. Operations included ventral/incisional hernia repairs, ostomy closures, parastomal hernia repairs, and inguinal hernia repairs. In 50 per cent of the patients, Permacol™ was used to reinforce a primary fascial repair and in 50 per cent as a fascial bridge. The overall complication rate was 39.5 per cent. The complication rate was higher in patients with infected versus clean wounds, body mass index (BMI) 40 kg/m2 or greater versus BMI less than 40 kg/m2, in patients with prior mesh repair, and when mesh was used as a fascial bridge. With a mean follow-up of 2.1 years, morbid obesity was associated with a higher recurrence. To date this is the largest study on the use of Permacol™ in abdominal wall hernia repair. In our patient population undergoing heterogeneous operations with a majority of wounds as Class II or higher, use of Permacol™ did not eliminate wound morbidity or prevent recurrence, especially in morbidly obese patients.

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