• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • COVID-19 Annoucements
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

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

Post Views: 55

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc