Abdominal wall reconstruction with components separation and mesh reinforcement in complex hernia repair

BMC Surgery

Research Article

Jason P Hodde¹  Paul S Rooney²  Claire L Nockolds² 

[1] Cook Biotech Incorporated, 1425 Innovation Place, 47906, West Lafayette, IN, USA;Royal Liverpool Hospital, Prescot Street, L7 8XP, Liverpool, Merseyside, UK;

关键词: Hernia;    Contamination;    Infection;    Components separation;    Biologic graft;    Mesh;    Reinforcement;   

DOI  :  10.1186/1471-2482-14-25

 received in 2013-10-09, accepted in 2014-04-01,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAbdominal closure in the presence of enterocutaneous fistula, stoma or infection can be challenging. A single-surgeon’s experience of performing components separation abdominal reconstruction and reinforcement with mesh in the difficult abdomen is presented.MethodsMedical records from patients undergoing components separation and reinforcement with hernia mesh at Royal Liverpool Hospital from 2009 to 2012 were reviewed. Patients were classified by the Ventral Hernia Working Group (VHWG) grading system. Co-morbidities, previous surgeries, specific type of reconstruction technique, discharge date, complications and hernia recurrence were recorded.ResultsTwenty-three patients’ (15 males, 8 females) notes were reviewed. Median age was 57 years (range 20-76 years). Median follow-up at the time of review was 17 months (range 2-48 months). There were 13 grade III hernias and 10 grade IV hernias identified. Synthetic mesh was placed to reinforce the abdomen in 6 patients, cross-linked porcine dermis was used in 3, and a Biodesign® Hernia Graft was placed in 14. Complications included wound infection (13%), superficial wound dehiscence (22%), seroma formation (22%) and stoma complications (9%). To date, hernias have recurred in 3 patients (13%).ConclusionsComponents separation and reinforcement with biological mesh is a successful technique in the grade III and IV abdomen with acceptable rate of recurrence and complications.

【 授权许可】

Unknown   
© Nockolds et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.