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Poly-4-hydroxybutyrate (Phasix™) mesh onlay in complex abdominal wall repair.
- Source :
-
Surgical endoscopy [Surg Endosc] 2021 May; Vol. 35 (5), pp. 2049-2058. Date of Electronic Publication: 2020 May 08. - Publication Year :
- 2021
-
Abstract
- Background: Poly-4-hydroxybutyric acid (P4HB, Phasix™) is a biosynthetic polymer that degrades by hydrolysis that can be woven into a mesh for use in soft tissue reinforcement. Herein, we describe our initial experience performing complex abdominal wall repair (CAWR) utilizing component separation and P4HB mesh as onlay reinforcement.<br />Methods: All patients undergoing CAWR between June 2014 and May 2017 were followed prospectively for postoperative outcomes. Only those patients who underwent components separation with primary repair of the fascial edges followed by onlay of P4HB mesh were included in this study.<br />Results: 105 patients (52 male, 53 female; mean age 59.2 years, range 22-84) met inclusion criteria. Mean BMI was 29.1 (range 16-48); 52% patients had prior attempted hernia repair, most with multiple medical comorbidities (71% of patients with ASA 3 or greater). 30% of cases were not clean at the time of repair (CDC class 2 or greater). Median follow-up was 36 months (range 9-63). Eighteen patients (17%) developed a hernia recurrence ranging from 2 to 36 months postoperatively. Five (5%) patients developed a localized superficial infection treated with antibiotics, three (2.8%) required re-operation for non-healing wounds, and six (6%) patients developed seroma.<br />Conclusions: These data demonstrate a relatively low rate of hernia recurrence, seroma, and other common complications of CAWR in a highly morbid patient population. Importantly, the rate of mesh infection was low and no patients required complete mesh removal, even when placed into a contaminated or infected surgical field.
- Subjects :
- Abdominoplasty adverse effects
Adult
Aged
Aged, 80 and over
Female
Hernia, Ventral surgery
Herniorrhaphy adverse effects
Herniorrhaphy instrumentation
Herniorrhaphy methods
Humans
Male
Middle Aged
Postoperative Complications etiology
Reoperation
Seroma etiology
Young Adult
Abdominal Wall surgery
Abdominoplasty instrumentation
Abdominoplasty methods
Polyesters
Surgical Mesh adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 35
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 32385706
- Full Text :
- https://doi.org/10.1007/s00464-020-07601-9