Ventral hernia repair after bowel surgery: does gastrointestinal contamination matter in the era of biologic mesh?

Abstract

BACKGROUND:

Ventral hernias are often repaired after planned or unplanned bowel procedures. Biologic materials are thought to better tolerate gastrointestinal contamination than synthetic alternatives. The purpose of this review was to evaluate the impact of intestinal contamination on ventral hernia repair with biologic material.

METHODS:

This is a retrospective review of all patients who underwent ventral hernia repair with biologic material between 2003 and 2012. Groups were defined based on performance of concomitant bowel surgery. Data were collected on patient demographics, risk factors, concomitant procedures, mesh type, and outcomes.

RESULTS:

Of 82 patients included in this series, 32 (39%) had concomitant bowel surgery. Ventral hernia repair was performed predominantly with Alloderm and Strattice. There was no difference in hernia recurrence (contaminated group-28% vs. non-contaminated group-34%, P = 0.58), surgical site infections (contaminated-28% vs. non-contaminated-20%, P = 0.40), or other complications when patients with and without concomitant bowel surgery were compared.

CONCLUSIONS:

Biologic materials have made it such that ventral hernias can be safely repaired after bowel surgery without increased risk of complications.

• Authors: Ximena A Pinell-White, Mark Gruszynski, Albert Losken
• Journal: Annals of plastic surgery (Ann Plast Surg) Vol. 72 Issue 6 Pg. S150-2 ( 2014) ISSN: 1536-3708 [Electronic] United States
• PMID: 24691329 (Publication Type: Journal Article)

Chemical References

• Alloderm
• strattice
• Collagen

Topics

• Collagen
• Female
• Gastrointestinal Tract (microbiology)
• Hernia, Ventral (surgery)
• Humans
• Intestinal Diseases (surgery)
• Male
• Middle Aged
• Recurrence
• Retrospective Studies
• Surgical Wound Infection (epidemiology)
• Wound Healing