Complications Following the Use of Biologic Mesh in Ileostomy Closure: A Retrospective, Comparative Study

Area of Science:

• Surgical Oncology
• Gastroenterology
• Biomaterials Science

Background:

• Prophylactic mesh placement during abdominal wall ileostomy closure can reduce hernia rates.
• Limited research exists on the safety of biologic mesh for ileostomy closure, particularly regarding infection-related complications.

Purpose of the Study:

• To evaluate the safety of biologic mesh in ileostomy closure, focusing on mesh removal due to infection.
• To compare surgical site infection (SSI), incisional hernia, surgical site occurrence (SSO), and wound pain between primary and mesh closure groups.

Main Methods:

• Retrospective analysis of consecutive patients undergoing ileostomy closure from January 2015 to June 2016.
• Exclusion criteria included stage IV colorectal cancer, age over 85, and intraoperative intestinal perforation.
• Comparison of demographic and clinical characteristics, including SSI, SSO, hospital stay, analgesic use, and pain scores (VAS).

Main Results:

• Of 33 analyzed patients, 18 had primary closure and 15 had mesh closure. Mean age was higher in the primary closure group (71 vs. 62 years).
• Complication rates were similar between groups (27.8% primary vs. 33.3% mesh). No mesh removal was required due to infection.
• No significant differences in SSI, incisional hernia rates, pain, or hospitalization length were observed between groups.

Conclusions:

• Biologic mesh closure for ileostomy is safe, with no mesh-related infectious complications requiring removal.
• No significant differences in SSI, incisional hernia, or wound pain were found compared to primary closure.
• Higher rates of hernia and SSOs in the mesh group warrant further investigation.