Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a randomised controlled trial
Viktor Holmdahl1,2, Ulf Gunnarsson3, Karin Strigård3
1Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden. viktor.holmdahl@umu.se.
Background:
Parastomal hernia is a common complication of an enterostomy and can have a significant impact on health-related quality of life. Currently used methods of repair have high recurrence rates and considerable risk for complications. We have developed a new technique for parastomal hernia repair that uses full-thickness skin graft as reinforcement.
Methods:
This study protocol describes a multicentre randomised controlled trial on parastomal hernia repair comparing a new full-thickness skin graft technique with conventional synthetic composite mesh as reinforcement of the abdominal wall. Patients with a symptomatic parastomal hernia will be included and followed up at 3, 12 and 36 months, with surgical complication as the primary outcome. Secondary outcomes will be recurrence rate and health-related quality of life assessed with VHPQ, EORTC C30 and CR29. Tissue biology and collagen metabolism will be investigated pre- and postoperatively using biopsies of the abdominal wall fascia and blood samples.
Discussion:
Parastomal hernia constitutes a major clinical problem where the prospects of a good result after hernia repair are presently poor. This new method of repair with full-thickness skin grafting could be a new alternative in our surgical toolbox, but before then, it must be evaluated properly.
Trial Registration:
ClinicalTrials.gov NCT03667287. Registered on September 12, 2018.
