Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a feasibility study

V Holmdahl,U Gunnarsson,K Strigård

doi:10.1007/s10151-020-02368-6

Abstract

BackgroundParastomal hernia is a common complication of stoma formation and the methods of repair available today are unsatisfactory with high recurrence and complication rates. To improve outcome after surgical repair of parastomal hernia, a surgical method using autologous full-thickness skin grafts as intraperitoneal reinforcement has been developed. The purpose of this study was to evaluate the feasibility of this novel surgical technique in the repair of parastomal hernia.MethodsA pilot study was conducted between January 2018 and June 2019 on four patients with symptomatic parastomal hernia. They had a laparotomy with suture reduction of the hernia and reinforcement of the abdominal wall with autologous full-thickness skin. They were then monitored for at least 1 year postoperatively for technique-related complications and recurrence.ResultsNo major technique-related complications were noted during the follow-up Two patients developed a recurrent parastomal hernia at the long term follow-up. The other two had no recurrence.ConclusionsAutologous full-thickness skin graft as reinforcement in parastomal hernia repair is feasible and should be evaluated in a larger clinical trial.

Highlights

Parastomal hernia (PSH) is a common complication after stoma formation, with an incidence in the literature of up to 78% [1–5]
Patients with suspected PSH on the waiting list for assessment by a specialist in abdominal wall surgery at our university hospital were considered for inclusion
Four patients were included in this pilot study from January 2018 to June 2019

Summary

Introduction

Parastomal hernia (PSH) is a common complication after stoma formation, with an incidence in the literature of up to 78% [1–5]. Parastomal hernia is a common complication of stoma formation and the methods of repair available today are unsatisfactory with high recurrence and complication rates. To improve outcome after surgical repair of parastomal hernia, a surgical method using autologous full-thickness skin grafts as intraperitoneal reinforcement has been developed. Methods A pilot study was conducted between January 2018 and June 2019 on four patients with symptomatic parastomal hernia They had a laparotomy with suture reduction of the hernia and reinforcement of the abdominal wall with autologous full-thickness skin. They were monitored for at least 1 year postoperatively for technique-related complications and recurrence. Conclusions Autologous full-thickness skin graft as reinforcement in parastomal hernia repair is feasible and should be evaluated in a larger clinical trial

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