Short-term Outcomes With Small Intestinal Submucosa for Ventral Abdominal Hernia

Abstract

Hypothesis:A bioabsorbable tissue scaffold of porcine submucosal small intestine extracellular matrix (Surgisis Gold [SIS]; Cook Biotech Inc, West Lafayette, Ind) mesh is safe and effective for ventral hernia repair.Design: Retrospective case series at a university teaching hospital.Patients: Fifty-three consecutive patients having 8-ply SIS mesh repair of ventral abdominal hernias. Main Outcome Measures:Early complications, reoperation, hernia recurrence, mesh or wound infection, or reaction. Outcomes reported and compared on an intention-to-treat basis.Results: Patients were stratified by wound class: clean, clean-contaminated and contaminated, or dirty. Median follow-up was 14 months (range, 2-29 months) during which there were 22 complications (41%), 17 early reoperations (32%), 13 partial dehiscences (21%), 6 mesh re-

A Systematic Review of Outcomes Following Repair of Complex Ventral Incisional Hernias With Biologic Mesh

“…From these eligible articles were found to have partial or complete data available for the population of interest and were used for the synthesis of results (Table 4). [14][15][16][17][18][19][20][21][22][23][24] These articles provided data regarding the following biologic mesh products: AlloDerm (n ¼ 7); Surgisis (n ¼ 2); CollaMend (n ¼ 2); Permacol (n ¼ 2); Strattice (n ¼ 1); and Veritas (n ¼ 1) (see Table 4 footnotes for manufacturers). None provided data on surgical repair procedures conducted using synthetic mesh or no mesh.…”

“…Among patients who underwent ventral hernia repair in the setting of a compromised surgical field, the most commonly reported reasons for a secondary surgical procedure included repair of recurrent hernia, mesh removal, drainage of seroma, and drainage of surgical site abscess. 16,18,22,24 Some authors highlighted the management of surgical site infection with antibiotics and wound care without mesh removal as a benefit of using biologic mesh. 14,16 Interpretative challenges…”

“…The 3 largest studies examined outcomes among patients (N ¼ 459) with a contaminated surgical field who underwent repair of ventral hernia (primary or recurrent) or abdominal wall repair for other indications using acellular human dermal matrix (AlloDerm). 16,17,21 Two other larger studies (N ¼ 53 18 and N ¼ 58 24 ) retrospectively reviewed outcomes following ventral hernia repair with a porcine submucosa-derived mesh [Surgisis Gold (SIS)] 18 or a variety of biologic mesh products 24 in the setting of a contaminated field. Across the 11 studies, 84 repairs were performed using components separation, and 17 involved laparoscopic repair.…”

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

“…The choice of this particular mesh was based on our institutional experience as well as other reports documenting that SIS mesh remodels into vascularized host tissue [13][14][15][16]. The main indication for the use of SIS biomaterial mesh was a contaminated field during gastrointestinal tract surgery or previous wound infection.…”

Minimally Invasive Surgical Technique in the Management of Perianal Fistulas Using the Surgisis® AFP Material

“…This has important implications for the entire treatment process, since reoperations are characterized by reduced efficiency (65). Preliminary medical data describing the resistance of the SIS (small intestine submucosa) material to infection with the possibility of active inflammation contamination (66,67,68) were not confirmed by studies concerning the treatment of anal fistulas. Therefore, proper eradication and perianal abscess drainage are recommended, prior to AFP plug implantations (55, 65,69).…”