Prospective, multicenter study of antimicrobial-coated, noncrosslinked, acellular porcine dermal matrix (XenMatrix™ AB Surgical Graft) for hernia repair in all centers for disease control and prevention wound classes: 24-month follow-up cohort

Obeid N Ilahi; George Velmahos; Jeffrey E Janis; Stephen J Kovach 3rd; Susan F McLean; Reza Askari; Courtney A Sommer; Suresh Agarwal; Jahnavi Srinivasan; Alex K Wong; Andrea Pakula; Edward P Miranda; Kerry Breen; Mark Shapiro; Corey R Deeken; R Cody Stringer; J Reed McGraw; Corey Bascone; Robert G Martindale

doi:10.1097/MS9.0000000000000695

Prospective, multicenter study of antimicrobial-coated, noncrosslinked, acellular porcine dermal matrix (XenMatrix™ AB Surgical Graft) for hernia repair in all centers for disease control and prevention wound classes: 24-month follow-up cohort

Ann Med Surg (Lond). 2023 Apr 19;85(5):1571-1577. doi: 10.1097/MS9.0000000000000695. eCollection 2023 May.

Authors

Obeid N Ilahi¹, George Velmahos², Jeffrey E Janis³, Stephen J Kovach 3rd⁴, Susan F McLean⁵, Reza Askari⁶, Courtney A Sommer⁷, Suresh Agarwal⁷, Jahnavi Srinivasan⁸, Alex K Wong⁹, Andrea Pakula¹⁰, Edward P Miranda¹¹, Kerry Breen², Mark Shapiro⁷, Corey R Deeken¹², R Cody Stringer¹², J Reed McGraw⁴, Corey Bascone⁴, Robert G Martindale¹³

Affiliations

¹ Washington University School of Medicine.
² Massachusetts General Hospital.
³ The Ohio State University, Columbus, OH.
⁴ University of Pennsylvania, Philadelphia, PA.
⁵ Texas Tech University Health Science Center School of Medicine, El Paso, TX.
⁶ Brigham and Women's Hospital, Boston, MA.
⁷ Duke University Medical Center, Durham, NC.
⁸ Emory University, Atlanta, GA.
⁹ City of Hope National Medical Center, Duarte, CA.
¹⁰ Kern Medical, Bakersfield.
¹¹ University of California San Francisco, San Francisco, CA.
¹² Covalent Bio, LLC, St. Louis, MO.
¹³ Oregon Health & Science University, Portland, OR.

Abstract

Prospective, multicenter, single-arm study of antimicrobial-coated, noncrosslinked, acellular porcine dermal matrix (AC-PDM) in a cohort involving all centers for disease control and prevention wound classes in ventral/incisional midline hernia repair (VIHR).

Materials and methods: Seventy-five patients (mean age 58.6±12.7 years; BMI 31.3±4.9 kg/m²) underwent ventral/incisional midline hernia repair with AC-PDM. Surgical site occurrence (SSO) was assessed in the first 45 days post-implantation. Length of stay, return to work, hernia recurrence, reoperation, quality of life, and SSO were assessed at 1, 3, 6, 12, 18, and 24 months.

Results: 14.7% of patients experienced SSO requiring intervention within 45 days post-implantation, and 20.0% thereafter (>45 d post-implantation). Recurrence (5.8%), definitely device-related adverse events (4.0%), and reoperation (10.7%) were low at 24 months; all quality-of-life indicators were significantly improved compared to baseline.

Conclusion: AC-PDM exhibited favourable results, including infrequent hernia recurrence and definitely device-related adverse events, with reoperation and SSO comparable to other studies, and significantly improved quality of life.

Keywords: XenMatrix AB surgical graft; hernia repair; minocycline; porcine dermal matrix; rifampin; surgical site occurrence.