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Mid-term outcomes after biologic mesh use: Does their performance meet our expectations?
P Brinas1, M Chalret du Rieu1, G Tuyeras1
1Chirurgie générale et digestive, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, 31059 Toulouse cedex 9, France.
Biological prostheses for hernia repair show high rates of recurrence and infection, questioning their clinical utility. Further comparison with semi-absorbable prostheses is needed to evaluate their effectiveness in abdominal wall reconstruction.
Area of Science:
- Surgical innovation
- Biomaterials in medicine
- Hernia repair techniques
Background:
- Biological mesh prostheses are costly and their use is limited, primarily for contaminated parietal repairs.
- Recent studies have questioned the efficacy of biological prostheses.
- This study evaluates outcomes of biological prosthesis use, focusing on hernia recurrence and infectious complications.
Purpose of the Study:
- To assess the efficacy of biological prostheses in hernia repair.
- To investigate rates of hernia recurrence and infectious complications following biological prosthesis implantation.
- To identify risk factors associated with recurrence.
Main Methods:
- Retrospective review of 68 patients who received biological prostheses between 2009 and 2015.
- Analysis of implantation sites (anterior abdominal wall, pelvis).
- Evaluation of early and medium-term post-operative outcomes, including complications and recurrence.
Main Results:
- High incidence of complications: 32.3% early wall abscess, 73% medium-term complications.
- Significant medium-term recurrence rate: 57% developed recurrent herniation.
- Risk factors for recurrence included parastomal hernia and prior hernia recurrence.
Conclusions:
- Biological prostheses are associated with a high rate of medium-term incisional hernia recurrence.
- The findings challenge the current use of biological prostheses in hernia repair.
- Comparative studies with semi-absorbable prostheses are warranted.
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