Onlay ventral hernia repairs using porcine non-cross-linked dermal biologic mesh

Area of Science:

• Surgical innovation
• Hernia repair techniques
• Biomaterials in surgery

Background:

• Ventral hernias are prevalent, with mesh repair reducing recurrence.
• Synthetic mesh carries infection risks; biologic mesh is an alternative.
• Onlay mesh placement is explored as an alternative to sublay for complex ventral hernias.

Purpose of the Study:

• To evaluate the outcomes of complex ventral hernia repair.
• To assess the efficacy of porcine non-cross-linked biologic mesh in an onlay position.

Main Methods:

• Retrospective review of ventral hernia repairs using biologic mesh (Jan 2009-Mar 2012).
• Open repair with primary fascial closure, component separation, and porcine biologic mesh onlay.
• Analysis of patient demographics, hernia grade, surgical approach, complications, and recurrence.

Main Results:

• 22 patients underwent repair; most were male with high-grade hernias post-cancer surgery.
• 16 patients (73%) had external oblique component separation; median hospital stay was 7 days.
• Two superficial infections occurred (no mesh removal); 6 patients (27%) developed seroma requiring drainage. No recurrence with primary closure.

Conclusions:

• Porcine non-cross-linked biologic mesh onlay demonstrates excellent short-term results for high-risk ventral hernia patients.
• No mesh removal was necessary, and primary fascial closure cases showed no recurrence.
• Biologic mesh bridging is not recommended for long-term abdominal wall reconstruction.