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04.09.2023 | Original Scientific Report

Outcomes of Complex Abdominal Wall Reconstruction with Biologic Mesh in Patients with 8 Years of Follow-Up

verfasst von: Abbas M. Hassan, Camila M. Franco, Nikhil R. Shah, Michael M. Talanker, Malke Asaad, Alexander F. Mericli, Jesse C. Selber, Charles E. Butler

Erschienen in: World Journal of Surgery | Ausgabe 12/2023

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Abstract

Background

While many studies evaluated outcomes of abdominal wall reconstruction with biologic mesh, long-term data is lacking. In this study, we sought to analyze the outcomes of complex AWR with biologic mesh in a robust cohort of patients with a mean follow up of 8 years.

Methods

We conducted a longitudinal study of AWR patients from 2005 to 2019. Hernia recurrence was the primary outcome, and surgical site occurrence was the secondary outcome. Predictive/protective factors were identified using a Cox proportional hazards regression models.

Results

We identified 109 consecutive patients who met the inclusion criteria. Patient’s mean (± SD) age was 57.5 ± 11.8 years, mean body mass index was 30.7 ± 7.2 kg/m², and mean follow-up time was 96.2 ± 15.9 months. Fifty-six percent had clean defects, 34% had clean-contaminated defects, and 10% had contaminated/infected defects. Patients had a mean defect size of 261 ± 199.6 cm² and mean mesh size of 391.3 ± 160.2 cm². Nineteen patients (17.4%) developed HR at the final follow-up date. Obesity was independently associated with a four-fold higher risk of HR (hazard ratio, 3.98; 95%CI, 1.34 to 14.60, p = 0.02). SSOs were identified in 24.8% of patients. A prior hernia repair was associated with a three-fold higher risk of SSOs (Odds ratio, 3.13; 95%CI, 1.10 to 8.94, p = 0.03). No patient developed mesh infection.

Conclusion

These longitudinal data demonstrate that complex AWR with biologic mesh provides long-term durable outcomes with acceptable HR and SSO rates despite high contamination levels, patients complexity, and large defect size.

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Titel: Outcomes of Complex Abdominal Wall Reconstruction with Biologic Mesh in Patients with 8 Years of Follow-Up
verfasst von: Abbas M. Hassan
Camila M. Franco
Nikhil R. Shah
Michael M. Talanker
Malke Asaad
Alexander F. Mericli
Jesse C. Selber
Charles E. Butler
Publikationsdatum: 04.09.2023
Verlag: Springer International Publishing
Erschienen in: World Journal of Surgery / Ausgabe 12/2023
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-023-07154-7

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Outcomes of Complex Abdominal Wall Reconstruction with Biologic Mesh in Patients with 8 Years of Follow-Up