Abstract
IntroductionThe approach to the abdominal wall surgical repair is dramatically changed in the last years. This study evaluates our institutional outcomes about the usage of biological meshes for abdominal wall repair in different setting: in elective surgery, in emergency surgery and in abdominal wall repair following open abdomen (OA) procedure.MethodsA database was prospectively conducted (January–December 2014) and data were reviewed for patients who underwent to an abdominal wall reconstruction with swine dermal non-cross linked collagens prostheses either in elective or emergency setting, and following OA/laparostomy procedure. Demographic data, co-morbidities, indications for surgery, intra-operative details, post-operative complications and outcome (peri-operative, 3, 6, 9-months) were analyzed.ResultsA total of 30 cases were reported: 9 in elective surgery (Group 1), 4 in emergency surgery (Group 2) and 17 with abdominal wall closure following OA management (Group 3). Two meshes were removed: 1 in the Group 1 and 1 in the Group 3. During follow-up only one patient in the Group 3 had a recurrence of the incisional hernia. Mortality rate was 11.1 % at 3 months in Group 1, 0 % in the Group 2, and 29.4 % in peri-operative period in the Group 3.ConclusionsThe use of non-cross linked biological meshes can be safe and versatile in different situations from elective to emergency surgery, and also for the reconstruction of the abdominal wall after OA procedure, with an acceptable recurrence and mortality rate.
Highlights
The approach to the abdominal wall surgical repair is dramatically changed in the last years
This study evaluates our institutional outcomes about the usage of biological meshes for abdominal wall repair in three different setting: in elective surgery, in emergency surgery and following open abdomen (OA)/laparostomy procedure
Thirty patients undergoing abdominal wall reconstruction with indication for biologic mesh placement and with swine dermal non-crosslinked collagen prostheses implant were enrolled in the study period
Summary
The approach to the abdominal wall surgical repair is dramatically changed in the last years. Procedures to repair abdominal wall defects are more than 990.000 each year in USA, with an estimated 567.000 of them performed in emergency [1, 2]. In most cases emergency hernia repair are performed in adults over 65 years old [2]. These age-related increasing rates of emergency hernia repair are associated with increased morbidity and Montori et al World Journal of Emergency Surgery (2015) 10:28 materials are difficult to drawn due to: lack of adequate follow-up, use either of different surgical techniques and/or different types of biological meshes and absence of high levels of evidence studies [7, 8]. There are many advantages in using biological meshes compared to the synthetic prostheses: less prosthetic erosions and/or fistulization, less chronic pain, and minor risk of infection [9]
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