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01-08-2021 | Original Article

Abdominal wall reconstruction with biosynthetic absorbable mesh after infected prosthesis explantation: single stage is better than two-stage approach of chronic mesh infection

Authors: J. Bueno-Lledó, M. Ceno, C. Pérez-Alonso, J. Martinez-Hoed, S. Pous-Serrano

Published in: Hernia | Issue 4/2021

Abstract

Purpose

To assess the efficacy of surgical management of chronic mesh infection (CMI) after abdominal wall hernia repair (AWHR) in single-stage approach (complete removal of infected prosthesis and simultaneous replacement with poly-4-hydroxybutyrate mesh or BAM group), comparing results with two-stage treatment (complete mesh excision and abdominal wall repair with synthetic mesh after several months or SPM group).

Methods

Retrospective comparative study of all patients who underwent surgery for CMI between January 2006 and January 2019 at a tertiary center. We compared results in terms of epidemiological data, hernia and prosthesis characteristics, surgical and postoperative variables of both two groups.

Results

Over the 13-year study period, 2791 AWHR was performed at our hospital; the overall CMI rate was 2.5%. Of 71 patients, 30 (42.2%) were in BAM group and 41 (57.8%) in SPM group. The median cumulative operative time (252 min versus 132 min) and length of stay (16.6 days versus 6.2 days) were significatively longer in SPM group compared with BAM group, due to the need of two surgical procedures. There were a higher number of postoperative complications in SPM group (p = 0.002), some of them grade III. With mean follow-up of 36.5 months (range 21–59), there were no significant differences in terms of overall hernia recurrence and mesh reinfection in both groups.

Conclusion

The use of a poly-4-hydroxybutyrate resorbable mesh in single-stage management of CMI may be a safe and better option than two-stage approach, although more studies are needed to confirm our results.

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Title: Abdominal wall reconstruction with biosynthetic absorbable mesh after infected prosthesis explantation: single stage is better than two-stage approach of chronic mesh infection
Authors: J. Bueno-Lledó
M. Ceno
C. Pérez-Alonso
J. Martinez-Hoed
S. Pous-Serrano
Publication date: 01-08-2021
Publisher: Springer Paris
Published in: Hernia / Issue 4/2021
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-020-02309-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abdominal wall reconstruction with biosynthetic absorbable mesh after infected prosthesis explantation: single stage is better than two-stage approach of chronic mesh infection

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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