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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 3/2020

Open Access 01-05-2020 | Wound Infection | Original Articles

Non-cross-linked biological mesh in complex abdominal wall hernia: a cohort study

Authors: Ruth Kaufmann, Friedrich-Eckart Isemer, Christoph W. Strey, Johannes Jeekel, Johan F. Lange, Guido Woeste

Published in: Langenbeck's Archives of Surgery | Issue 3/2020

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Abstract

Purpose

Complex abdominal wall hernia repair (CAWHR) is a challenging procedure. Mesh prosthesis is indicated, but the use of synthetic mesh in a contaminated area may add to overall morbidity. Biological meshes may provide a solution, but little is known about long-term results. The aim of our study was to evaluate clinical efficacy and patient satisfaction following Strattice™ (PADM) placement.

Methods

In this cohort study, all patients operated for CAWHR with PADM in three large community hospitals in Germany were included. Patients underwent abdominal examination, an ultrasound was performed, and patients completed quality-of-life questionnaires. The study was registered in ClinicalTrials.​gov under Identifier NCT02168231.

Results

Twenty-seven patients were assessed (14 male, age 67.5 years, follow-up 42.4 months). The most frequent postoperative complication was wound infection (39.1%). In no case, the PADM had to be removed. Four patients had passed away. During outpatient clinic visit, six out of 23 patients (26.1%) had a recurrence of hernia, one patient had undergone reoperation. Five patients (21.7%) had bulging of the abdominal wall. Quality-of-life questionnaires revealed that patients judged their scar with a median 3.5 out of 10 points (0 = best) and judged their restrictions during daily activities with a median of 0 out of 10.0 (0 = no restriction).

Conclusions

Despite a high rate of wound infection, no biological mesh had to be removed. In some cases, therefore, the biological meshes provided a safe way out of desperate clinical situations. Both the recurrence rate and the amount of bulging are high (failure rate 47.8%). The reported quality of life is good after repair of these complex hernias.
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Metadata
Title
Non-cross-linked biological mesh in complex abdominal wall hernia: a cohort study
Authors
Ruth Kaufmann
Friedrich-Eckart Isemer
Christoph W. Strey
Johannes Jeekel
Johan F. Lange
Guido Woeste
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 3/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-020-01881-4

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