Single institutional experience using biological mesh for abdominal wall reconstruction

Am J Surg. 2014 Sep;208(3):480-4; discussion 483-4. doi: 10.1016/j.amjsurg.2013.09.020. Epub 2013 Dec 25.

Abstract

Background: Complex ventral hernias remain a challenge. We present a study evaluating outcomes of complex ventral hernia repair using human-derived acellular dermal matrix (AlloDerm) and porcine-derived acellular dermal sheet (Permacol).

Methods: A retrospective review of 251 patients undergoing complex hernia repair was performed. Primary outcome was hernia recurrence; and secondary outcomes included early and late complications and mortality.

Results: Recurrence for Permacol versus AlloDerm was 32% versus 47% (P = .02). There was a difference in early complications (48% vs 30%, P = .007) and also late complications (30% vs 21%, P = .16) of Permacol versus AlloDerm. Overall survival was 85% for the Permacol group versus 78% for the AlloDerm group (P = .23). Recurrence for Permacol versus AlloDerm for underlay technique was 19% versus 22% and that for bridging technique was 44% versus 57%.

Conclusion: There exists a high complication rate from both Permacol and AlloDerm in complex ventral hernia repair especially when used as a fascial bridge.

Keywords: Abdominal wall; Biologic; Hernia; Mesh; Ventral hernia.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Abdominal Wall / surgery*
  • Adult
  • Aged
  • Collagen*
  • Female
  • Hernia, Ventral / surgery
  • Herniorrhaphy / instrumentation*
  • Herniorrhaphy / methods
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Proportional Hazards Models
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh*
  • Treatment Outcome

Substances

  • Alloderm
  • Permacol
  • Collagen