Skip to main content
Erschienen in: Surgical Endoscopy 4/2018

15.09.2017

Ventral hernia repair with poly-4-hydroxybutyrate mesh

verfasst von: Margaret A. Plymale, Daniel L. Davenport, Adam Dugan, Amanda Zachem, John Scott Roth

Erschienen in: Surgical Endoscopy | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Biomaterial research has made available a biologically derived fully resorbable poly-4-hydroxybutyrate (P4HB) mesh for use in ventral and incisional hernia repair (VIHR). This study evaluates outcomes of patients undergoing VIHR with P4HB mesh.

Methods

An IRB-approved prospective pilot study was conducted to assess clinical and quality of life (QOL) outcomes for patients undergoing VIHR with P4HB mesh. Perioperative characteristics were defined. Clinical outcomes, employment status, QOL using 12-item short form survey (SF-12), and pain assessments were followed for 24 months postoperatively.

Results

31 patients underwent VIHR with bioresorbable mesh via a Rives–Stoppa approach with retrorectus mesh placement. The median patient age was 52 years, median body mass index was 33 kg/m2, and just over half of the patients were female. Surgical site occurrences occurred in 19% of patients, most of which were seroma. Hernia recurrence rate was 0% (median follow-up = 414 days). Patients had significantly improved QOL at 24 months compared to baseline for SF-12 physical component summary and role emotional (p < 0.05).

Conclusions

Ventral hernia repair with P4HB bioresorbable mesh results in favorable outcomes. Early hernia recurrence was not identified among the patient cohort. Quality of life improvements were noted at 24 months versus baseline for this cohort of patients with bioresorbable mesh. Use of P4HB mesh for ventral hernia repair was found to be feasible in this patient population. (ClinicalTrials.gov Identifier: NCT01863030).
Literatur
3.
Zurück zum Zitat Buinewicz B, Rosen B (2004) Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair. Ann Plas Surg 52:188–194CrossRef Buinewicz B, Rosen B (2004) Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair. Ann Plas Surg 52:188–194CrossRef
5.
Zurück zum Zitat Luijendijk RW, Hop WCJ, van den Tol MP, de Lange DCD, Braaksma MMJ, IJzermans JNM, Boelhouwer RU, de Vries BC, Salu MKM, Wereldsma JCJ, Bruijninckx C, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398. doi:10.1056/NEJM200008103430603 CrossRefPubMed Luijendijk RW, Hop WCJ, van den Tol MP, de Lange DCD, Braaksma MMJ, IJzermans JNM, Boelhouwer RU, de Vries BC, Salu MKM, Wereldsma JCJ, Bruijninckx C, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398. doi:10.​1056/​NEJM200008103430​603 CrossRefPubMed
9.
Zurück zum Zitat Fayezizadeh M, Majumder A, Belyansky I, Novitsky YW (2016) Outcomes of retromuscular porcine biologic mesh repairs using transversus abdominis release reconstruction. J Am Coll Surg 223:461–468CrossRefPubMed Fayezizadeh M, Majumder A, Belyansky I, Novitsky YW (2016) Outcomes of retromuscular porcine biologic mesh repairs using transversus abdominis release reconstruction. J Am Coll Surg 223:461–468CrossRefPubMed
10.
Zurück zum Zitat Majumder A, Winder JS, Wen Y, Pauli E, Belyansky I, Novitsky YW (2016) Comparative analysis of biologic versus synthetic mesh outcomes in contaminated hernia repairs. Surgery 160:828–838CrossRefPubMed Majumder A, Winder JS, Wen Y, Pauli E, Belyansky I, Novitsky YW (2016) Comparative analysis of biologic versus synthetic mesh outcomes in contaminated hernia repairs. Surgery 160:828–838CrossRefPubMed
12.
Zurück zum Zitat Carbonell AM, Criss CN, Cobb WS, Novitsky YW, Rosen MJ (2013) Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg 217:991–998CrossRefPubMed Carbonell AM, Criss CN, Cobb WS, Novitsky YW, Rosen MJ (2013) Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg 217:991–998CrossRefPubMed
13.
Zurück zum Zitat Cobb WS, Carbonell AM, Kalbaugh CL, Jones Y, Lokey JS (2009) Infection risk of open placement of intraperitoneal composite mesh. Am Surg 75:762–768PubMed Cobb WS, Carbonell AM, Kalbaugh CL, Jones Y, Lokey JS (2009) Infection risk of open placement of intraperitoneal composite mesh. Am Surg 75:762–768PubMed
15.
Zurück zum Zitat Deeken CR, Matthews BD (2013) Characterization of the mechanical strength, resorption properties, and histologic characteristics of a fully absorbable material (poly-4-hydroxybutyrate—PHASIX Mesh) in a porcine model of hernia repair. ISRN Surg. doi:10.1155/2013/238067 PubMedPubMedCentral Deeken CR, Matthews BD (2013) Characterization of the mechanical strength, resorption properties, and histologic characteristics of a fully absorbable material (poly-4-hydroxybutyrate—PHASIX Mesh) in a porcine model of hernia repair. ISRN Surg. doi:10.​1155/​2013/​238067 PubMedPubMedCentral
16.
Zurück zum Zitat Martin DP, Badhwar A, Shah DV, Rizk S, Eldridge SN, Gagne DH, Ganatra A, Darois RE, Williams SF, Tai H-C, Scott JR (2013) Characterization of poly-4-hydroxybutyrate mesh for hernia repair applications. J Surg Res 184:766–773. doi:10.1016/j.jss.2013.03.044 CrossRefPubMed Martin DP, Badhwar A, Shah DV, Rizk S, Eldridge SN, Gagne DH, Ganatra A, Darois RE, Williams SF, Tai H-C, Scott JR (2013) Characterization of poly-4-hydroxybutyrate mesh for hernia repair applications. J Surg Res 184:766–773. doi:10.​1016/​j.​jss.​2013.​03.​044 CrossRefPubMed
17.
Zurück zum Zitat Bauer JJ, Harris MT, Gorfine SR, Kreel I (2002) Rives–Stoppa procedure for repair of large incisional hernias: experience with 57 patients. Hernia 6:120–123CrossRefPubMed Bauer JJ, Harris MT, Gorfine SR, Kreel I (2002) Rives–Stoppa procedure for repair of large incisional hernias: experience with 57 patients. Hernia 6:120–123CrossRefPubMed
20.
Zurück zum Zitat Holihan JL, Alawadi Z, Martindale RG, Roth JS, Wray CJ, Ko TC, Kao LS, Liang MK (2015) Adverse events after ventral hernia repair: the vicious cycle of complications. J Am Coll Surg 221:478–485CrossRefPubMed Holihan JL, Alawadi Z, Martindale RG, Roth JS, Wray CJ, Ko TC, Kao LS, Liang MK (2015) Adverse events after ventral hernia repair: the vicious cycle of complications. J Am Coll Surg 221:478–485CrossRefPubMed
21.
Zurück zum Zitat Helgstrand F, Rosenberg J, Kehlet H, Jorgensen LN, Bisgaard T (2013) Nationwide prospective study of outcomes after elective incisional hernia repair. J Am Coll Surg 216:217–228CrossRefPubMed Helgstrand F, Rosenberg J, Kehlet H, Jorgensen LN, Bisgaard T (2013) Nationwide prospective study of outcomes after elective incisional hernia repair. J Am Coll Surg 216:217–228CrossRefPubMed
22.
Zurück zum Zitat Scott JR, Deeken CR, Martindale RG, Rosen MJ (2016) Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair. Surg Endosc 30:3691–3701CrossRefPubMedPubMedCentral Scott JR, Deeken CR, Martindale RG, Rosen MJ (2016) Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair. Surg Endosc 30:3691–3701CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Tedelin S, Westbert F, Kjerrulf M, Vidal A (2007) Anti-inflammatory properties of the short-chain fatty acids acetate and propionate: a study with relevance to inflammatory bowel disease. World J Gastroenterol 13:2826–2832CrossRef Tedelin S, Westbert F, Kjerrulf M, Vidal A (2007) Anti-inflammatory properties of the short-chain fatty acids acetate and propionate: a study with relevance to inflammatory bowel disease. World J Gastroenterol 13:2826–2832CrossRef
24.
Zurück zum Zitat Wang F, Liu J, Wong T, Shen K, Chen Z, Yu Y, Huang Q, Wang G, Jin S (2016) The inflammation induced by lipopolysaccharide can be mitigated by short chain fatty acid, butyrate, through up-regulation of IL-10 in septic shock. Scand J Immunol. doi:10.1111/sji.12515 Wang F, Liu J, Wong T, Shen K, Chen Z, Yu Y, Huang Q, Wang G, Jin S (2016) The inflammation induced by lipopolysaccharide can be mitigated by short chain fatty acid, butyrate, through up-regulation of IL-10 in septic shock. Scand J Immunol. doi:10.​1111/​sji.​12515
25.
Zurück zum Zitat Kokotovic D, Bisgaard T, Helgstrand F (2016) Long-term recurrence and complications associated with elective incisional hernia repair. JAMA 316:1575–1582CrossRefPubMed Kokotovic D, Bisgaard T, Helgstrand F (2016) Long-term recurrence and complications associated with elective incisional hernia repair. JAMA 316:1575–1582CrossRefPubMed
Metadaten
Titel
Ventral hernia repair with poly-4-hydroxybutyrate mesh
verfasst von
Margaret A. Plymale
Daniel L. Davenport
Adam Dugan
Amanda Zachem
John Scott Roth
Publikationsdatum
15.09.2017
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 4/2018
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5848-7

Weitere Artikel der Ausgabe 4/2018

Surgical Endoscopy 4/2018 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.