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Non-cross-linked biological mesh in complex abdominal wall hernia: a cohort study
Ruth Kaufmann1,2, Friedrich-Eckart Isemer3,4, Christoph W Strey5
1Department of Surgery, Erasmus University Medical Center, Room Ee-173, Wytemaweg 80, NL-3015 CN, Rotterdam, The Netherlands. ruth.kaufmann@gmail.com.
Langenbeck'S Archives of Surgery
|April 24, 2020
Summary
This study on biological mesh for complex abdominal wall hernia repair found high infection and recurrence rates but no mesh removal. Patients reported good quality of life despite these complications.
Area of Science:
- Surgical innovation in hernia repair.
- Biomaterials in reconstructive surgery.
- Patient outcomes in complex abdominal surgery.
Background:
- Complex abdominal wall hernia repair (CAWHR) presents challenges, particularly with mesh placement in contaminated fields.
- Synthetic meshes carry risks in contaminated surgical sites, prompting interest in biological alternatives.
- Long-term efficacy data for biological meshes in CAWHR are limited.
Purpose of the Study:
- To evaluate the clinical efficacy of using Permacol™ (PADM) for complex abdominal wall hernia repair.
- To assess patient satisfaction and quality of life following PADM placement in CAWHR.
- To determine the complication and recurrence rates associated with PADM in CAWHR.
Main Methods:
- A cohort study including patients undergoing CAWHR with PADM across three German hospitals.
- Data collection involved abdominal examinations, ultrasound assessments, and patient-reported quality-of-life questionnaires.
- The study was registered on ClinicalTrials.gov (Identifier: NCT02168231).
Main Results:
- Twenty-seven patients (14 male, mean age 67.5 years) with a mean follow-up of 42.4 months were analyzed.
- The most common postoperative complication was wound infection (39.1%); no PADM removal was necessary.
- Hernia recurrence occurred in 26.1% of patients, with 21.7% experiencing abdominal wall bulging, leading to a 47.8% failure rate.
Conclusions:
- PADM can be a viable option in complex hernia cases, even with high infection rates, as no mesh removal was required.
- The study highlights significant rates of recurrence and bulging, indicating a high failure rate.
- Despite surgical complications, patients reported good quality of life following complex abdominal wall hernia repair with PADM.
