Bovine versus porcine acellular dermal matrix for abdominal wall herniorrhaphy or bridging.
Background: The management of complicated ventral hernias (CVH), namely ventral hernias in actively or recently infected/contaminated operative fields, and open abdomens in which the native fascia cannot be primarily reapproximated, pose a surgical challenge. Fetal Bovine and Porcine Acellular Derma...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 48; no. 3; pp. 1993 - 2002 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157411438&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157411438 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Jun2022 vid: 48 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 157411438 149235130 157411438 157411438 10.1007/s00068-021-01641-z 157411438 ppf: 1993 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Bovine versus porcine acellular dermal matrix for abdominal wall herniorrhaphy or bridging. aug: au: Van Orden, Kathryn Santos, Jeffrey Stanfield, Brent Frost, Landon S. Ruditsky, Alexander Foster, Andrea Brahmbhatt, Tejal S. Burke, Peter A. Fernandez-Moure, Joseph Haines, Krista Agarwal, Suresh Kasotakis, George affil: Division of Trauma, Acute Care Surgery and Surgical Critical Care, Boston Medical Center, Boston University School of Medicine, 02118, Boston, MA, USA sug: subj: Dermis Surgery Hernia Surgery Herniorrhaphy Methods Biocompatible Materials Therapeutic Use Surgical Mesh Tertiary Health Care Urban Areas Academic Medical Centers Human Treatment Outcomes Postoperative Period Comparative Studies Retrospective Design Record Review Interviews Cox Proportional Hazards Model Regression Recurrence Risk Factors Risk Assessment Descriptive Statistics Immunosuppression ab: Background: The management of complicated ventral hernias (CVH), namely ventral hernias in actively or recently infected/contaminated operative fields, and open abdomens in which the native fascia cannot be primarily reapproximated, pose a surgical challenge. Fetal Bovine and Porcine Acellular Dermal Matrix (BADM and PADM) biologic meshes are being increasingly used in these scenarios. A comparison, however, of clinically relevant outcomes between the two is lacking. With this investigation, we aim to review and compare clinically relevant outcomes in patients that underwent abdominal wall herniorrhaphy with either BADM or PADM at a tertiary urban academic institution over a 5-year period. Methods: Patients who had a BADM or PADM implanted during CVH over a 5-year period at a tertiary urban academic hospital were identified. Baseline clinical and hernia characteristics, as well as postoperative outcomes were compared after a retrospective chart review. Phone interviews were also conducted to assess for recurrence, followed by in-person visits as indicated. Cox Proportional Hazard regression was fitted to identify risk factors for recurrence. Results: Of the 140 patients who underwent biologic mesh implantation for CVH, 109 were for ventral hernia repair and 31 for open abdomen bridging. Mean age was 52.7 ± 14.2 and males constituted 57.9% of our sample, while 25.1% had undergone > 5 prior abdominal operations. Thirty percent were active smokers, and another 30% required emergency surgery. Only immunosuppression was a risk factor for recurrence [HR 13.3 (1.04–169.2), p = 0.047] on Cox Proportional Hazard regression, while mesh selection had no effect. Conclusions: Both BADM and PADM meshes perform well in CVH, with satisfactory recurrence rates, only slightly higher compared to traditional synthetic mesh repairs. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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