Biologic mesh for repair of ventral hernias in contaminated fields: long-term clinical and patient-reported outcomes

Madani, Amin; Niculiseanu, Petru; Marini, Wanda; Kaneva, Pepa; Mappin‐Kasirer, Benjamin; Vassiliou, Melina C.; Khwaja, Kosar; Fata, Paola; Fried, Gerald M.; Feldman, Liane S.

doi:10.1007/s00464-016-5044-1

Cited by 30 publications

(24 citation statements)

References 35 publications

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“…The justification of the high cost of composite or biological mesh is particularly related to its need in the contaminated surgical environment, when the use of polypropylene mesh is forbidden [9][10][11].…”

Section: Results and Disscusionsmentioning

confidence: 99%

The Role of the Composite and Biologic Meshes in the Trocar Site Hernia Repair Following Laparoscopic Surgery

Socea¹,

Carâp²,

Bratu³

et al. 2018

Mat.Plast.

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The increasing proportion of laparoscopic interventions in the surgical centers has, also, determined an increased incidence of specific complications, such as trocar hernia. Nowadays, there is no unanimously agreed concensus regarding the optimal closure technique of the trocar incision, wether it should include the suture of the aponeurosis or not at the 10 mm ports. There is, also, no consensus regarding the proper surgical technique for the trocar hernia repair- alloplastic or tissue repair technique.The purpose of the study is to present our experience on the alloplastic repair of the trocar hernias. It is a retrospective study that analyzes the results obtained by our clinicalteam regarding the alloplastic repair of the trocar hernias, over a five-year period, between January 2011 and December 2015. The recurrence and the occurrence rates of different complications (seroma, neuroma with postoperative pain, parietal infiltration, infections and mesh rejection), depending on the type of mesh used for the surgical repair,are studied.

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Section: Results and Disscusionsmentioning

confidence: 99%

The Role of the Composite and Biologic Meshes in the Trocar Site Hernia Repair Following Laparoscopic Surgery

Socea¹,

Carâp²,

Bratu³

et al. 2018

Mat.Plast.

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“…A previous in vitro study has shown that Surgisis ® has a higher bacterial load than other polymer materials, when incubated with Staphylococcus [22], which might indicate that it should be avoided in contaminated surgical fields. Similarly, a clinical study on hernia repair has indicated that the frequency of wound infections could be high when Surgisis ® is used [14].…”

Section: Discussionmentioning

confidence: 99%

“…It is produced from the small intestine submucosa, is biodegradable and works as an acellular scaffold that is incorporated and neovascularised in animal models and in humans [12][13][14][15][16]. This is the first study on the usage of Surgisis ® as an adjunct in breast reconstruction in a larger series.…”

Section: Introductionmentioning

confidence: 99%

Complications, long-term outcome and quality of life following Surgisis® and muscle-covered implants in immediate breast reconstruction: a case-control study with a 6-year follow-up

et al. 2018

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Background Matrices are now commonly used in breast reconstruction, but the scientific evidence is still scares. The main aim was to compare complications and the need for corrections in immediate breast reconstruction with the porcine-derived Surgisis ® with the traditional muscle-covered technique. The secondary aim was to compare long-term quality of life and satisfaction. Methods All consecutive patients who had their breast reconstructed with a Surgisis ® or muscle-covered tissue expander/implant were included. Patients were followed clinically and with BREAST-Q. Results During the study period, 116 reconstructions (71 patients) were operated in the Surgisis ® group and 132 reconstructions (90 patients) in the control group. The median follow-up time was 74 months (min 43-max 162). The total early complication rate was 37% in the Surgisis ® group and 27% in the control group. There were no differences in implant loss (p = 0.68) or total number of complications (p = 0.24) between the two groups. Risk factors for complications were mainly patient characteristics and the use of a tissue expander. There was a slightly higher capsular contracture frequency in the Surgisis ® patients (4.2% vs. 2.5%). The need for corrections and patient satisfaction and quality of life were similar in the two groups. Conclusions The use of Surgisis ® in implant-based reconstruction seems to result in an acceptable total early complication rate. The rate might be higher in tissue expander-based reconstruction. Risk factors are mainly patient characteristics. The capsular contracture rate and need for corrections, as well as patient satisfaction and quality of life, are similar in the Surgisis ® patients and muscle-covered controls. Level of evidence: III

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“…The degree of contamination in all studies was clean-contaminated. Mesh placement was reported as intraperitoneal in five studies 34,35,42,44,46 , extraperitoneal in seven 30,32,33,37,40,48,50 and a combination in ten studies 29,31,36,38,39,41,43,45,47,49 . One study 28 26 2015 Greece Prophylaxis Bovine pericardium 36 Maggiori et al 24 2015 France Prophylaxis Strattice™ 17 Ueno et al 29 2004 USA Reinforcement Surgisis ® 16 Limpert et al 37 2009 USA Reinforcement Bovine pericardium 22 Hsu et al 35 2009 USA Reinforcement Permacol™ 16 Chavarriaga et al 32 2010 USA Reinforcement Permacol™ 7 Cox et al 48 2010 USA Reinforcement Surgisis ® 10 Shah et al 45 2011 elective and emergency operations.…”

Section: Ideal Stage Of Innovation and Grade Quality Of Evidencementioning

confidence: 99%

“…Seven 29,31,38,40,48 -50 were of very low quality, 14 30,32 -37,39,42-47 of low quality, and two 28,41 of moderate quality. None reported standardization of technique or location of biological mesh placement; the choice of mesh type was based on the preference of operating surgeon.Of the eight studies evaluating biological mesh for mixed indications, four included patients undergoing elective surgery and the remaining four studies included both…”

mentioning

confidence: 96%

Systematic review of the stage of innovation of biological mesh for complex or contaminated abdominal wall closure

et al. 2018

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BackgroundAchieving stable closure of complex or contaminated abdominal wall incisions remains challenging. This study aimed to characterize the stage of innovation for biological mesh devices used during complex abdominal wall reconstruction and to evaluate the quality of current evidence.MethodsA systematic review was performed of published and ongoing studies between January 2000 and September 2017. Eligible studies were those where a biological mesh was used to support fascial closure, either prophylactically after midline laparotomy, or for reinforcement after repair of incisional hernia with midline incision. The primary outcome measure was the IDEAL framework stage of innovation. The key secondary outcome measure was the GRADE criteria for study quality.ResultsThirty‐five studies including 2681 patients were included. Four studies considered mesh prophylaxis, 23 considered hernia repair, and eight reported on both. There was one published randomized trial (IDEAL stage 3), none of which was of high quality; the others were non‐randomized studies (IDEAL stage 2a). A detailed description of surgical technique was provided in most studies (27 of 35); however, no study reported outcomes according to the European Hernia Society consensus statement and only two described quality control of surgical technique during the study. From 21 ongoing randomized trials and observational studies, 11 considered repair of incisional hernia and 10 considered prophylaxis (seven in elective settings).ConclusionThe evidence base for biological mesh is limited, and better reporting and quality control of surgical techniques are needed. Although results of ongoing trials over the next decade will improve the evidence base, further study is required in the emergency and contaminated settings.

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Biologic mesh for repair of ventral hernias in contaminated fields: long-term clinical and patient-reported outcomes

Abstract: Hernia recurrences and wound infections are high with the use of biologic PSIS mesh in contaminated surgical fields. Careful consideration is warranted using this approach.

Cited by 30 publications

References 35 publications

The Role of the Composite and Biologic Meshes in the Trocar Site Hernia Repair Following Laparoscopic Surgery

The Role of the Composite and Biologic Meshes in the Trocar Site Hernia Repair Following Laparoscopic Surgery

Complications, long-term outcome and quality of life following Surgisis® and muscle-covered implants in immediate breast reconstruction: a case-control study with a 6-year follow-up

Systematic review of the stage of innovation of biological mesh for complex or contaminated abdominal wall closure

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