Repair of abdominal wall defects with bovine pericardium

Am J Surg. 2009 Nov;198(5):e60-5. doi: 10.1016/j.amjsurg.2009.01.027. Epub 2009 Oct 6.

Abstract

Background: Ventral hernia repair with prosthetic mesh has recurrence rates up to 54% and is contraindicated in the setting of infection. The aim of this study was to provide our experience with acellular bovine pericardium (Veritas collagen matrix; Synovis Life Technologies, Inc., St. Paul, MN) in complex abdominal wall reconstruction where prosthetic mesh had failed or was contraindicated. Between 2005 and 2008, a retrospective review of a single general surgeon's practice identified patients reconstructed with acellular bovine pericardium. Thirty primary or recurrent ventral hernias were treated in 26 patients. All patients presented with either contaminated wounds or failure of a prosthetic mesh material.

Results: Hernia size ranged from 20 cm(2) to 600 cm(2) (mean 111 cm(2)). Seven patients had previous hernia repair with prosthetic mesh, and 16 patients had ongoing infection or gross contamination at the time of repair. The mean follow-up was 22 months. The hernia recurrence rate in our series was 19% with no fistula development.

Conclusions: Acellular bovine pericardium's high strength, minimal infection rate, and low cost allow its use in the reconstruction of complex abdominal wall defects.

MeSH terms

  • Abdominal Wall / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Biocompatible Materials / economics
  • Biocompatible Materials / therapeutic use*
  • Cattle
  • Collagen / economics
  • Collagen / therapeutic use*
  • Cost Savings
  • Fasciotomy
  • Female
  • Hernia, Ventral / pathology
  • Hernia, Ventral / surgery*
  • Humans
  • Male
  • Middle Aged
  • Missouri
  • Negative-Pressure Wound Therapy
  • Pericardium / transplantation*
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Surgical Mesh
  • Wound Infection / surgery
  • Young Adult

Substances

  • Alloderm
  • Biocompatible Materials
  • Collagen