.Reconstruction of complex hernias of abdominal wall can be asso- ciated with a high complication rate. Placement of synthetic prosthetic mesh in a contaminated/potentially contaminated field may lead to infection and subsequent mesh removal. In these cases, bio- logical meshes could be used. These new materials are all essentially composed of an extracel- lular matrix without its cellular components and substantially differ in their source (porcine small intestine submucosa, porcine dermis or cadaveric human dermis) and in cross-linking. From March 2007 fifteen patients underwent repair of complex hernias of abdominal wall with biological meshes. Indications included patients treated with immunosuppressive therapies following liver or kidney transplantation (3 cases), immunologic diseases (2 cases), synchronous colonic surgery (4 cases), acute cholecystitis (4 cases) and treatment of parastomal hernia (2 cases). On two patients with parastomal hernia, a midline hernia (in both cases) and a perineal hernia (in one case) were associated. In all cases cross-linked porcine dermal collagen meshes (13 Permacol, Covidien and 5 Colla Mend, Bard) were used. Complications occurred in 3 patients (1 abdominal wall abscess, 1 intra-abdominal abscess, 1 haematoma) requiring a second surgical look but despite of the presence of contamination it was unnecessary to remove the mesh. At follow-up (min 3 mos.- max 22 mos) no recurrence or bulging were observed. Biological meshes can be used in patients in which the use of synthetic materials might be problematic such as (potentially) con- taminated environment or immunologic problems. Although no large series are actually available in literature, from preliminary data they seem to represent a safe and acceptable alternative in such circum- stances. The European Hernia Society (EHS) Registry for Biological Prostheses (ERBP) will allow to better understand the current use and outcome of biological meshes (Hernia 2009, 13:103–108).
P69 - Biological prostheses for complex abdominal wall repair / Gossetti, Francesco; D'Amore, Linda; Andreuccetti, J; Dassatti, Mr; Cereatti, Fabrizio; Negro, Paolo. - In: HERNIA. - ISSN 1265-4906. - STAMPA. - 13:Suppl 1(2009), pp. S95-S95. [10.1007/s10029-009-0544-8]
P69 - Biological prostheses for complex abdominal wall repair
GOSSETTI, Francesco;D'AMORE, Linda;CEREATTI, FABRIZIO;NEGRO, Paolo
2009
Abstract
.Reconstruction of complex hernias of abdominal wall can be asso- ciated with a high complication rate. Placement of synthetic prosthetic mesh in a contaminated/potentially contaminated field may lead to infection and subsequent mesh removal. In these cases, bio- logical meshes could be used. These new materials are all essentially composed of an extracel- lular matrix without its cellular components and substantially differ in their source (porcine small intestine submucosa, porcine dermis or cadaveric human dermis) and in cross-linking. From March 2007 fifteen patients underwent repair of complex hernias of abdominal wall with biological meshes. Indications included patients treated with immunosuppressive therapies following liver or kidney transplantation (3 cases), immunologic diseases (2 cases), synchronous colonic surgery (4 cases), acute cholecystitis (4 cases) and treatment of parastomal hernia (2 cases). On two patients with parastomal hernia, a midline hernia (in both cases) and a perineal hernia (in one case) were associated. In all cases cross-linked porcine dermal collagen meshes (13 Permacol, Covidien and 5 Colla Mend, Bard) were used. Complications occurred in 3 patients (1 abdominal wall abscess, 1 intra-abdominal abscess, 1 haematoma) requiring a second surgical look but despite of the presence of contamination it was unnecessary to remove the mesh. At follow-up (min 3 mos.- max 22 mos) no recurrence or bulging were observed. Biological meshes can be used in patients in which the use of synthetic materials might be problematic such as (potentially) con- taminated environment or immunologic problems. Although no large series are actually available in literature, from preliminary data they seem to represent a safe and acceptable alternative in such circum- stances. The European Hernia Society (EHS) Registry for Biological Prostheses (ERBP) will allow to better understand the current use and outcome of biological meshes (Hernia 2009, 13:103–108).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
