T S Auer, Prof, J Pfeifer, Prof, J Waha, MD. University of Graz, Austria, Dept of Surgery
Introduction: Biological meshes were thought to solve the problem of infected hernia situations and complex hernia in high risk patients. However, recent results were disappointing for the benefit of the use of these cost intensive and infection triggering materials.
In vitro and animal studies have demonstrated an enhanced bacterial growth and late hydrolysis, after 15 to 18 months, for P4HB, and the remaining scar tissue of high strength.
Methods and Procedures: Between September 2015 and September 2016, 17 Patient were operated for complex infected hernia (9), large hernia after liver transplantation (6), complex ventral hernia in multi morbid high risk patients (2) (mainly cardiac, renal, endocrine, pulmonary risk factors).
The meshes were placed mainly in onlay position, in some cases in sublay or a supplemented enforcement onlay position when a permanent mesh was placed in sublay position (sandwich).
Results: All cases showed a primary healing tendency, no mesh has been explanted. The main complication was observed with 2 cases of seromas, one of them infected. 3 Patients were re-operated due to skin necrosis. The onlay meshes in these cases were kept in site and were observed with excellent granulation activity (picture documented). No hernia recurrence was seen in the first 12 months.
Conclusions: The use of P4 HB meshes showed to be an excellent plan B for very complicated and infected hernia cases that need repair. Onlay position of these meshes is not an additive risk factor also in complicated skin situation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79506
Program Number: P035
Presentation Session: Poster (Non CME)
Presentation Type: Poster