WTP5.7 The use of porcine dermal acellular matrix mesh for ventral and parastomal hernia: an evaluation of outcomes from a tertiary centre

Abstract

Abstract Aims and Objectives Despite advancements in techniques for abdominal wall closure, 15-20% develop incisional hernia. Synthetic meshes are ill-advised for ventral-hernia repair at risk of wound-complications. Biologic grafts are an alternative given their biocompatible safety-profile. We evaluated the outcomes of fascial closure using a Porcine Dermal Acellular Matrix (PDAM) mesh (Cellis®). Methods A retrospective PDAM-mesh review was performed between 01/05/2016-30/09/2022, focusing on midline/parastomal hernias. Electronic charts were reviewed to obtain demographic and surgical data. Immediate/short-/long-term complications and radiological recurrence rates were collected. Results 71 cases (acute/elective 10/61, F:M 4:3) were included in the study, median age 62yrs (25-93yrs), follow-up 12-72mos. Majority (69%) of the elective group had ASA2 vs. 70% acutes had ASA3. Of the 61 elective repairs, midline hernias constituted 37 (60%) and parastomal hernias in 24 (40%). Of the 10 acute cases, there were 8 midline-hernias and 2 parastomal-hernias. Component separation (CS) were performed in 29 cases (16-bilateral anterior-CS, 11-unilateral anterior-CS and 2-bilateral posterior-CS). Median LOS was 11d (1-180d)/15d (1-159d) for elective/acute groups. Seromas and minor wound infections were the commonest short-term Cx in both groups. There were 5 deaths within 90-days. From the elective group 6/37 (16%) midline repairs and 8/24 (33%) parastomal hernias had CT recurrences. In the acute group, one recurrence each were noted from 8 midline repairs (12%) and 2 parastomal hernias. Conclusion Our PDAM-mesh cohort demonstrates acceptable results regarding managing midline-ventral and parastomal-hernias in the elective/acute setting. Further comparative studies with synthetic mesh are warranted to fully evaluate the effectiveness of PDAM meshes.