Abstract | BACKGROUND: Large ventral hernia repair represents a major reconstructive surgical challenge, especially under contaminated conditions. Synthetic mesh is usually avoided in these circumstances because of fear of mesh infection, although evidence is outdated and does not regard new materials and techniques. The authors evaluated the safety of synthetic mesh in large contaminated ventral hernia repair. METHODS: RESULTS: One hundred thirty-seven patients were included, with a mean age of 58.6 years, mean body mass index of 26.6 cm2, and mean defect size of 235.6 cm2. Surgical-site infection and total wound complication rates were 16.1 and 48.9 percent, respectively. The surgical wound class distribution of surgical-site infections was as follows: clean, five of 56 (9.1 percent); clean-contaminated, five of 34 (14.7 percent); contaminated, three of 19 (15.8 percent); and dirty/infected, nine of 28 (32.1 percent). Seven meshes (5.1 percent) needed removal, two after clean repairs, three after clean-contaminated repairs, and two after dirty/infected repairs. Surgical wound class (OR, 1.77; 95 percent CI, 1.20 to 2.61) and Ventral Hernia Working Group grade (OR, 2.31; 95 percent CI, 1.24 to 4.28) were predictors of surgical-site infection. CONCLUSION:
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Authors | Nicholas J Slater, Loes Knaapen, Willem J V Bökkerink, Marleen J A Biemans, Otmar R Buyne, Dietmar J O Ulrich, Robert P Bleichrodt, Harry van Goor |
Journal | Plastic and reconstructive surgery
(Plast Reconstr Surg)
Vol. 136
Issue 6
Pg. 796e-805e
(Dec 2015)
ISSN: 1529-4242 [Electronic] United States |
PMID | 26595034
(Publication Type: Clinical Study, Journal Article)
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Topics |
- Adult
- Aged
- Equipment Design
- Female
- Hernia, Ventral
(microbiology, pathology, surgery)
- Herniorrhaphy
(methods)
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Surgical Mesh
- Surgical Wound Infection
(epidemiology)
- Young Adult
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