Skip to main content
Erschienen in: Irish Journal of Medical Science (1971 -) 2/2012

01.06.2012 | Original Article

Initial experience of double-layer tension free reconstruction of abdominal wall defects with porcine acellular dermal collagen implant and polypropylene mesh

verfasst von: F. M. Shaikh, T. E. Kennedy, E. G. Kavanagh, P. A. Grace

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

Abstract

Introduction and aim

Various techniques have been proposed for the repair of abdominal wall defects (AWD) with varying rates of success. Despite the development of new materials and modifications of surgical technique, no single approach has emerged as the optimum way to close large AWD. We report a method for repairing large incisional and recurrent abdominal wall hernias using a double-mesh technique. The defect is closed using an underlay biological implant and an onlay synthetic mesh, which is ‘quilted’ to the underlying abdominal wall and biological implant. The current study reports our initial experience with this approach in ten consecutive patients operated on for large AWD.

Methods

In this prospective observational study the following data were collected: age, gender, previous surgery, co-morbidities, situation and size of the defect, antibiotic therapy, hospital stay, postoperative complications and bacteriology in case of infection. The patients were reviewed at 1, 3 and 6 months, and 1-year postsurgery.

Results

Overall all ten AWD of ≥75 cm2 were reconstructed successfully using the quilting technique. Median age of patients was 61 years (range 47–73 years); male:female ratio was 3:2 and median weight was 107.5 kg. Two patients developed a wound infection and were treated successfully with antibiotics. At median follow-up of 15.5 months (range 6–29 months) there was no case of recurrence.

Conclusion

The use of double-layer of porcine acellular dermal collagen implant and polypropylene mesh in reconstruction of AWD can be considered a safe and effective treatment. The early short-term results are encouraging with few complications.
Literatur
1.
Zurück zum Zitat Keith WM (2003) Incisional hernia repair. Surg Clin N Am 83:1223–1224CrossRef Keith WM (2003) Incisional hernia repair. Surg Clin N Am 83:1223–1224CrossRef
2.
Zurück zum Zitat den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW (2008) Open surgical procedures for incisional hernias. Cochrane Database Syst Rev:CD00643 den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW (2008) Open surgical procedures for incisional hernias. Cochrane Database Syst Rev:CD00643
3.
Zurück zum Zitat Bringman S, Conze J, Cuccurullo D et al (2010) Hernia repair: the search for ideal meshes. Hernia 14:81–87PubMedCrossRef Bringman S, Conze J, Cuccurullo D et al (2010) Hernia repair: the search for ideal meshes. Hernia 14:81–87PubMedCrossRef
4.
Zurück zum Zitat Harper C (2001) Permacol: clinical experience with a new biomaterial. Hosp Med 62:90–95PubMed Harper C (2001) Permacol: clinical experience with a new biomaterial. Hosp Med 62:90–95PubMed
5.
Zurück zum Zitat Saray A (2003) Porcine dermal collagen [Permacol] for facial contour augmentation: preliminary report. Aesthet Plast Surg 27:368–375PubMedCrossRef Saray A (2003) Porcine dermal collagen [Permacol] for facial contour augmentation: preliminary report. Aesthet Plast Surg 27:368–375PubMedCrossRef
6.
Zurück zum Zitat Moore RD, Miklos JR, Kohli N (2004) Rectovaginal fistula repair using a porcine dermal graft. Obstet Gynecol 104:1165–1167PubMedCrossRef Moore RD, Miklos JR, Kohli N (2004) Rectovaginal fistula repair using a porcine dermal graft. Obstet Gynecol 104:1165–1167PubMedCrossRef
7.
Zurück zum Zitat Giri SK, Drumm J, Saunders JA et al (2005) Day-case sling surgery for stress urinary incontinence: feasibility and safety. BJU Int 95:827–832PubMedCrossRef Giri SK, Drumm J, Saunders JA et al (2005) Day-case sling surgery for stress urinary incontinence: feasibility and safety. BJU Int 95:827–832PubMedCrossRef
8.
Zurück zum Zitat Pentlow A, Smart NJ, Richards SK, Inward CD, Morgan JDT (2008) The use of porcine dermal collagen implants in assisting abdominal wall closure of pediatric renal transplant recipients with donor size discrepancy. Pediatr Transpl 12:20–23CrossRef Pentlow A, Smart NJ, Richards SK, Inward CD, Morgan JDT (2008) The use of porcine dermal collagen implants in assisting abdominal wall closure of pediatric renal transplant recipients with donor size discrepancy. Pediatr Transpl 12:20–23CrossRef
9.
Zurück zum Zitat Cobb GA, Shaffer J (2005) Cross-linked acellular porcine dermal collagen implant in laparoscopic ventral hernia repair: case-controlled study of operative variables and early complications. Int Surg 90:S24–S29PubMed Cobb GA, Shaffer J (2005) Cross-linked acellular porcine dermal collagen implant in laparoscopic ventral hernia repair: case-controlled study of operative variables and early complications. Int Surg 90:S24–S29PubMed
10.
Zurück zum Zitat Shaikh FM, Giri SK, Durrani S, Waldron D, Grace PA (2007) Experience with porcine acellular dermal collagen implant in one-stage tension-free reconstruction of acute and chronic abdominal wall defects. World J Surg 31:1966–1972PubMedCrossRef Shaikh FM, Giri SK, Durrani S, Waldron D, Grace PA (2007) Experience with porcine acellular dermal collagen implant in one-stage tension-free reconstruction of acute and chronic abdominal wall defects. World J Surg 31:1966–1972PubMedCrossRef
11.
Zurück zum Zitat de Vries Reilingh TS, van Geldere D, Langenhorst B et al (2004) Repair of large midline incisional hernias with polypropylene mesh: comparison of three operative techniques. Hernia 8:56–59PubMedCrossRef de Vries Reilingh TS, van Geldere D, Langenhorst B et al (2004) Repair of large midline incisional hernias with polypropylene mesh: comparison of three operative techniques. Hernia 8:56–59PubMedCrossRef
12.
Zurück zum Zitat Brown GL, Richardson JD, Malangoni MA, Tobin GR, Ackerman D, Polk HC Jr (1985) Comparison of prosthetic materials for abdominal wall reconstruction in the presence of contamination and infection. Ann Surg 201:705–711PubMedCrossRef Brown GL, Richardson JD, Malangoni MA, Tobin GR, Ackerman D, Polk HC Jr (1985) Comparison of prosthetic materials for abdominal wall reconstruction in the presence of contamination and infection. Ann Surg 201:705–711PubMedCrossRef
13.
Zurück zum Zitat Jones JW, Jurkovich GJ (1989) Polypropylene mesh closure of infected abdominal wounds. Am Surg 55:73–76PubMed Jones JW, Jurkovich GJ (1989) Polypropylene mesh closure of infected abdominal wounds. Am Surg 55:73–76PubMed
14.
15.
Zurück zum Zitat Klinge U, Klosterhalfen B, Müller M, Schumpelick V (1999) Foreign body reaction to meshes used for the repair of abdominal wall hernias. Eur J Surg 165:665–673PubMedCrossRef Klinge U, Klosterhalfen B, Müller M, Schumpelick V (1999) Foreign body reaction to meshes used for the repair of abdominal wall hernias. Eur J Surg 165:665–673PubMedCrossRef
16.
Zurück zum Zitat LeBlanc KA, Whitaker JM (2002) Management of chronic postoperative pain following incisional hernia repair with Composix mesh: a report of two cases. Hernia 6:194–197PubMedCrossRef LeBlanc KA, Whitaker JM (2002) Management of chronic postoperative pain following incisional hernia repair with Composix mesh: a report of two cases. Hernia 6:194–197PubMedCrossRef
17.
Zurück zum Zitat Mathes SJ, Steinwald PM, Foster RD, Hoffman WY, Anthony JP (2000) Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg 232:586–596PubMedCrossRef Mathes SJ, Steinwald PM, Foster RD, Hoffman WY, Anthony JP (2000) Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg 232:586–596PubMedCrossRef
18.
Zurück zum Zitat de Vries Reilingh TS, van Goor H, Rosman C et al (2003) “Component separation technique” for the repair of large abdominal wall hernias. J Am Coll Surg 196:32–37PubMedCrossRef de Vries Reilingh TS, van Goor H, Rosman C et al (2003) “Component separation technique” for the repair of large abdominal wall hernias. J Am Coll Surg 196:32–37PubMedCrossRef
19.
Zurück zum Zitat Lowe JB 3rd, Lowe JB, Baty JD, Garza JR (2003) Risks associated with “component separation” for closure of complex abdominal wall defects. Plast Reconstr Surg 111:1276–1283PubMedCrossRef Lowe JB 3rd, Lowe JB, Baty JD, Garza JR (2003) Risks associated with “component separation” for closure of complex abdominal wall defects. Plast Reconstr Surg 111:1276–1283PubMedCrossRef
20.
Zurück zum Zitat Shaikh FM, Kennedy TE, Coyle P, Kavanagh EG, Grace PA (2011) Diastasis as a cause of recurrence in ventral herniorrhaphy with porcine acellular dermal collagen implant. Plast Reconstr Surg 127:167e–169ePubMedCrossRef Shaikh FM, Kennedy TE, Coyle P, Kavanagh EG, Grace PA (2011) Diastasis as a cause of recurrence in ventral herniorrhaphy with porcine acellular dermal collagen implant. Plast Reconstr Surg 127:167e–169ePubMedCrossRef
21.
Zurück zum Zitat Leber GE, Carb JL, Alexander AI, Reed WP (1998) Long term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382PubMedCrossRef Leber GE, Carb JL, Alexander AI, Reed WP (1998) Long term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382PubMedCrossRef
Metadaten
Titel
Initial experience of double-layer tension free reconstruction of abdominal wall defects with porcine acellular dermal collagen implant and polypropylene mesh
verfasst von
F. M. Shaikh
T. E. Kennedy
E. G. Kavanagh
P. A. Grace
Publikationsdatum
01.06.2012
Verlag
Springer-Verlag
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 2/2012
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-011-0776-3

Weitere Artikel der Ausgabe 2/2012

Irish Journal of Medical Science (1971 -) 2/2012 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

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