Bioprosthetic mesh use for the problematic thoracoabdominal wall: outcomes in relation to contamination and infection

Abstract Background Limited controlled data exist regarding the role of bioprosthetic meshes for hernia repair. Often the only option available in contaminated cases, their high cost calls for an evaluation of their utility and indications for use. Methods A retrospective review of cases in which hu...

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Bibliographic Details
Published in:The American journal of surgery 2012-05, Vol.203 (5), p.594-597
Main Authors: Ouellet, Jean-Francois, M.D, Ball, Chad G., M.D, Kortbeek, John B., M.D, Mack, Lloyd A., M.D, Kirkpatrick, Andrew W., M.D
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Wall - microbiology
Abdominal Wall - surgery
Antibiotics
Biological and medical sciences
Bioprosthesis
bioprosthetic mesh
Cancer
Female
Fistula
General aspects
Hernias
Herniorrhaphy
human acellular dermal matrix
Humans
Infection - complications
Infection - surgery
Infections
Length of stay
Liver cirrhosis
Male
Medical sciences
Middle Aged
Ostomy
Patients
Prostheses
Retrospective Studies
Skin
Surgery
Surgical Mesh
Surgical techniques
Thoracic Wall - microbiology
Thoracic Wall - surgery
Thoracoabdominal wall hernia
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Summary:Abstract Background Limited controlled data exist regarding the role of bioprosthetic meshes for hernia repair. Often the only option available in contaminated cases, their high cost calls for an evaluation of their utility and indications for use. Methods A retrospective review of cases in which human acellular dermal matrix (HADM) was used to reconstruct a thoracoabdominal wall defect at the Foothills Medical Centre of Calgary was conducted. Attention was placed to identify the need for surgical reintervention postoperatively. Results Over 2 years, 13 patients required the use of HADM for reconstruction of their thoracoabdominal wall; 69.2% of the cases were contaminated or infected. Three patients (23.1%) presented postoperative infectious complications; only 1 required reoperation. No patients required removal of their prosthesis. Two patients presented recurrences (median follow-up = 126 days). Conclusions The use of HADM for complex thoracoabdominal wall defects in contaminated or infected settings is a reliable option available for surgeons.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2012.01.008