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Repair of abdominal wall defects with bovine pericardium

https://doi.org/10.1016/j.amjsurg.2009.01.027Get rights and content

Abstract

Background

Ventral hernia repair with prosthetic mesh has recurrence rates up to 54% and is contraindicated in the setting of infection. The aim of this study was to provide our experience with acellular bovine pericardium (Veritas collagen matrix; Synovis Life Technologies, Inc., St. Paul, MN) in complex abdominal wall reconstruction where prosthetic mesh had failed or was contraindicated. Between 2005 and 2008, a retrospective review of a single general surgeon's practice identified patients reconstructed with acellular bovine pericardium. Thirty primary or recurrent ventral hernias were treated in 26 patients. All patients presented with either contaminated wounds or failure of a prosthetic mesh material.

Results

Hernia size ranged from 20 cm2 to 600 cm2 (mean 111 cm2). Seven patients had previous hernia repair with prosthetic mesh, and 16 patients had ongoing infection or gross contamination at the time of repair. The mean follow-up was 22 months. The hernia recurrence rate in our series was 19% with no fistula development.

Conclusions

Acellular bovine pericardium's high strength, minimal infection rate, and low cost allow its use in the reconstruction of complex abdominal wall defects.

Section snippets

Materials and Methods

Between 2005 and 2008, a retrospective review of a single general surgeon's practice was conducted to identify patients reconstructed with acellular bovine pericardium. A total of 30 primary or recurrent ventral hernias were treated in 26 patients with acellular bovine pericardium. All patients had either contaminated wounds or failure of a prosthetic mesh material and were thus selected to undergo repair with acellular bovine pericardium. Active abdominal infections with or without infected

Results

Twenty-six patients with a total of 30 hernias were treated. There were 18 women and 8 men ranging in age from 22 to 84 years old (mean age 54 years). Hernias ranged in size from 20 cm2 to 600 cm2 (mean 111 cm2). Seven patients had undergone previous hernia repair procedures with prosthetic mesh. Sixteen patients (61%) had ongoing infection or gross contamination at the time of repair, and 2 patients had a prior history of methicillin-resistant Staphylococcal aureus infections. All cases

Comments

Ventral hernias complicate nearly 11% of abdominal surgery procedures.26, 27 Associated morbidity from these hernias includes both incarceration and strangulation. The prevention of hernias is ideal, but their occurrence is often unavoidable. Multiple techniques are extent in the literature for hernia repair; however, even with tension-free repair, recurrence rates are quoted as high as 54%.1, 2, 3, 4 Hernia recurrences are often complicated by infection or extrusion of mesh and occur in

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    Dr. Limpert received an honorarium as a speaker for Synovis Life Technologies.

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