Chemotherapy does not adversely impact outcome following post‐incisional hernia repair with biomaterial mesh

Abstract

Background: Patients receiving chemotherapy are at increased risk for developing recurrent or post-incisional hernias (PIH). Biological materials are an alternative to synthetic mesh in contaminated fields. The impact of chemotherapy on biomaterial tissue ingrowth and integration has not been well studied. Methods: From 2008 to 2011 patients who underwent PIH repair with biomaterial mesh (Biodesign 1 ) were selected. Patients were divided into two groups: those receiving chemotherapy (CT) and those not receiving chemotherapy (NCT). Results: Forty-five patients were identified, 28 (62%) in the NCT group and 17 (38%) in the CT group. Median follow up for NCT and CT groups were 27 and 17 months, respectively. A total of 9/45 (20%) surgical site infections (SSI) were diagnosed, with 6/28 (21%) in the NCT and 3/17 (18%) in the CT group (P ¼ 0.53). Seroma formation was seen in 5/28 (18%) of NCT patients and 4/17 (23%) in CT group (P ¼ 0.46). Overall hernia recurrence rate was 22%, and the rates of recurrence were similar among the CT 3/17 (18%) and NCT 7/28 (25%) groups (P ¼ 0.42). Conclusion: The use of perioperative chemotherapy did not increase the rate of wound complications following PIH repair with biologic mesh in this group of patients.

Hernia and Cancer: The Points Where the Roads Intersect

“…Immunosuppression due to chemotherapeutic agents or malignancy itself can not only increase the infection risk but may also result in higher recurrence rates because of impaired inflammatory response to tissue integration and scar formation. A retrospective series revealed that surgical site occurrence rates after incisional hernia repair with biological mesh did not differ between the groups receiving or not receiving chemotherapy (187). However, some problems might arise when synthetic meshes are used instead of expensive biological meshes.…”

Post-incisional ventral hernia repair in patients undergoing chemotherapy: improving outcomes with biological mesh

“…The recent diffusion of biologic materials-based meshes has lowered infection rates and overall complication rates in high-risk patients [ 3 , 11 ]. For these reasons, we performed this retrospective study to evaluate the usefulness and safety of the use of BIOMESH in high-risk patients who underwent chemotherapy in a short time frame.…”

“…Post-incisional ventral hernia (VH) is a common complication after abdominal surgery reaching an incidence that ranges between 2 and 20% according to the literature [ 1 – 3 ]. Several factors are related with its presentation depending on both technical aspects and patient characteristics; type of abdominal incision, suture materials, surgical technique, and type of mesh used to repair the defect are important technical factors to consider as well as advanced age, high BMI, post-operative septic complications and corticosteroid treatment [ 4 , 5 ].…”

“…Biologic materials-based meshes (BIOMESH) have recently emerged as a useful option to repair VH in high-risk patients; these meshes in fact, carry a lower risk of infection and degrade in septic fields thus avoiding the necessity of removal [ 3 , 10 ]. Piazzese et al in 2004 demonstrated no differences in terms of wound complications and VH recurrence in liver-transplanted patients undergoing incisional hernia repair comparing synthetic mesh with biological mesh [ 11 ].…”

“…Piazzese et al in 2004 demonstrated no differences in terms of wound complications and VH recurrence in liver-transplanted patients undergoing incisional hernia repair comparing synthetic mesh with biological mesh [ 11 ]. Moreover, in a recent study, Saied et al concluded that chemotherapy administration did not increase the rate of wound complications in their series of patients undergoing VH repair with biomaterial mesh [ 3 ]. Despite this, no data comparing the use of synthetic mesh with BIOMESH in high-risk patients undergoing chemotherapy are available in the literature.…”