• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / A Risk Prediction Model for Synthetic Mesh Remodeling and Collagen Distribution After Abdominal Wall Reconstruction: An Analysis of Explants By Host Characteristics and Surgical Site Classifications

A Risk Prediction Model for Synthetic Mesh Remodeling and Collagen Distribution After Abdominal Wall Reconstruction: An Analysis of Explants By Host Characteristics and Surgical Site Classifications

Jaime A Cavallo, MD, MPHS, Andres A Roma, MD, Jingxia Liu, PhD, Jenny Ousley, BS, Jennifer Creamer, MD, Sara Baalman, MA, Margaret M Frisella, RN, Brent D Matthews, MD, Corey R Deeken, PhD

Section of Minimally Invasive Surgery, Department of Surgery, Washington University School of Medicine; Division of Biostatistics, Washington University School of Medicine; Department of Anatomic Pathology, Cleveland Clinic

INTRODUCTION: The ability to predict from preoperative patient characteristics and surgical site classifications the patients for whom synthetic meshes are most likely to successfully remodel and develop favorable collagen type ratios would be of great clinical value. We hypothesized that higher collagen type I:III ratios and more favorable histologic remodeling scores of explanted scaffolds would directly correlate with duration of scaffold indwelling, and inversely correlate with hernia diameter; history of diabetes, alcohol abuse (ETOH), radiation to the abdomen or pelvis (RAD), chemotherapy, and corticosteroid use; as well as the age, body mass index (BMI), obesity class, American College of Surgeons wound class, and Ventral Hernia Working Group (VHWG) hernia grade of the subject assessed at the time of both scaffold implantation (T1) and explantation (T2).

METHODS: Biopsies of synthetic meshes were obtained from abdominal wall repair sites of n=24 patients during subsequent abdominal re-explorations. Biopsies were H&E stained, and evaluated according to a semi-quantitative scoring system for characteristics of remodeling [cell infiltration (CI), cell types (CT), host extracellular matrix deposition (ECM), inflammation (IF), fibrous encapsulation (FE), and neovascularization (NEO)], and mean composite remodeling score (CR). Mesh biopsies were also stained with sirius red (SR) for collagen I and fast green (FG) for collagen III, photographed under polarized light, and analyzed for SR:FG ratio. Univariate analyses were performed with two-tailed Kruskal-Wallis tests at a significance level of α=0.05. Significant variables from the univariate analyses were used in multivariate linear regression models.

RESULTS: Mean subject age at T1 and T2, M:F ratio, ratio of onlay:inlay:sublay location, and mean duration of scaffold indwelling were 55.01 ± 12.95 years, 57.07 ± 12.40 years, 6:18, 2:3:15, and 1195.35 ± 1331.59 days, respectively. IF and mean CR significantly correlated with, and CT trended toward significance with subject race (p=0.0272, 0.0205, and p=0.0521, respectively). Mean CR trended toward significance with BMI at T1 (p=0.0541). CT significantly correlated with VHWG hernia grade at T2 (p=0.0034). IF significantly correlated with subject history of tobacco use (p=0.0365), and FE, mean SR, and mean SR/FG ratio significantly correlated with cigarette packs per day (p=0.0483, 0.0149, 0.0485, respectively). ECM, FE, and NEO significantly correlated with duration of mesh indwelling in days (p=0.0328, 0.0285, 0.0325, respectively). Following multivariate linear regression, only cigarette packs per day and subject BMI at T1 were significantly correlated with mean FG (p=0.0157, 0.0014, respectively).

CONCLUSION: Host characteristics and surgical site assessments may predict degree of remodeling following abdominal wall repair for synthetic meshes. Patient factors significantly correlated with synthetic mesh remodeling include race, history and quantity of tobacco use, BMI at time of mesh implantation, duration of mesh indwelling, and VHWG hernia grade at time of mesh explantation. Quantity of collagen III, which confers less mechanical strength to tissue than collagen I, significantly correlated in multivariate analysis with cigarette packs per day and host BMI at the time of the mesh implantation for abdominal wall reinforcement.


Session: Poster Presentation

Program Number: P020

77

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals