Bioprosthetic mesh use for the problematic thoracoabdominal wall: outcomes in relation to contamination and infection

Am J Surg. 2012 May;203(5):594-597. doi: 10.1016/j.amjsurg.2012.01.008. Epub 2012 Mar 23.

Abstract

Background: Limited controlled data exist regarding the role of bioprosthetic meshes for hernia repair. Often the only option available in contaminated cases, their high cost calls for an evaluation of their utility and indications for use.

Methods: A retrospective review of cases in which human acellular dermal matrix (HADM) was used to reconstruct a thoracoabdominal wall defect at the Foothills Medical Centre of Calgary was conducted. Attention was placed to identify the need for surgical reintervention postoperatively.

Results: Over 2 years, 13 patients required the use of HADM for reconstruction of their thoracoabdominal wall; 69.2% of the cases were contaminated or infected. Three patients (23.1%) presented postoperative infectious complications; only 1 required reoperation. No patients required removal of their prosthesis. Two patients presented recurrences (median follow-up = 126 days).

Conclusions: The use of HADM for complex thoracoabdominal wall defects in contaminated or infected settings is a reliable option available for surgeons.

MeSH terms

  • Abdominal Wall / microbiology
  • Abdominal Wall / surgery*
  • Bioprosthesis*
  • Female
  • Herniorrhaphy*
  • Humans
  • Infections / complications
  • Infections / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Surgical Mesh*
  • Thoracic Wall / microbiology
  • Thoracic Wall / surgery*