Related Experiment Video
Updated: Aug 13, 2026
05:47
Use of a Rat Model to Study Ventral Abdominal Hernia Repair
Published on: October 2, 2017
9.2K
Onlay Resorbable Biosynthetic Versus Underlay Biologic Mesh Ventral Hernia Repair in Contaminated Fields
Chris Amro1, Jane N Ewing2, Dominic J Romeo2
1Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania; Hansjörg Wyss Department of Plastic Surgery, NYU Langone, New York, New York.
The Journal of Surgical Research
|January 5, 2025
Summary
Resorbable biosynthetic mesh may be better than biologic mesh for contaminated ventral hernia repair (VHR) with abdominal wall reconstruction (AWR). Biosynthetic mesh showed fewer surgical site occurrences and interventions, potentially lowering patient burden.
Area of Science:
- Abdominal surgery
- Biomaterials science
- Hernia repair
Background:
- Contaminated abdominal wall reconstruction (AWR) with ventral hernia repair (VHR) presents significant surgical challenges.
- The choice of mesh material and placement technique is critical in these complex cases.
- Comparing onlay resorbable biosynthetic mesh with underlay biologic mesh is essential for optimizing outcomes.
Purpose of the Study:
- To evaluate the efficacy of onlay resorbable biosynthetic mesh versus underlay biologic mesh in contaminated VHR with AWR.
- To compare complication rates, including surgical site occurrences (SSOs) and recurrence rates.
- To assess the impact of mesh choice on patient outcomes in contaminated surgical fields.
Main Methods:
- A single-center retrospective review of patients undergoing VHR with AWR in contaminated fields (CDC wound class II-IV) from 2015 to 2021.
- Matched paired analysis comparing resorbable biosynthetic mesh (onlay) with biologic mesh (underlay) based on patient demographics and wound classification.
- Evaluation of outcomes including SSOs, need for SSO interventions, and hernia recurrence.
Main Results:
- 94 patients (47 per group) were analyzed, with the biosynthetic mesh group showing significantly fewer SSOs (46.8% vs. 72.3%, P < 0.05) and SSO interventions (19.1% vs. 38.4%, P < 0.05).
- While the biosynthetic mesh group had numerically fewer hernia recurrences (14.9% vs. 30.4%), this difference was not statistically significant (P = 0.07).
- The study included patients with large defect sizes, high rates of component separation, and a majority of clean-contaminated wounds.
Conclusions:
- Resorbable biosynthetic mesh may offer advantages over biologic mesh in contaminated VHR with AWR, leading to reduced surgical site occurrences.
- Lower rates of SSOs and interventions associated with biosynthetic mesh could decrease the postoperative clinical and financial burden.
- Further investigation may be warranted to confirm the statistically significant reduction in hernia recurrence rates.
Related Concept Videos
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:21Inflammatory Bowel Disease V: Surgical Management
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
01:25Hiatal Hernia
A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...