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Long-term outcomes of PGA-TMC absorbable synthetic scaffold in both clean and contaminated ventral hernia repairs

  • 2023 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Biosynthetic meshes afford the cost advantages of being made from fully synthetic material, but are also biodegradable, making them a versatile option that can be used in both clean and contaminated cases. The aim of this study is to evaluate the safety profile and long-term outcomes of using GORE BIO-A (BIO-A) as an adjunct to abdominal wall reconstruction in all wound classes.

Methods

A retrospective review identified patients undergoing abdominal hernia repair using BIO-A from October 2008 to June 2018. The primary outcome was hernia recurrence rate. Only patients with at least 6-month follow-up were included when looking at recurrence rates. Secondary outcomes included 30-day morbidity categorized according to CDC Surgical Site Infection Criteria, return to operating/procedure room (RTOR), 30-day readmission, length of stay (LOS), and mortality.

Results

A total of 207 patients were identified, CDC Wound Classification breakdown was 127 (61.4%), 41 (19.8%), 14 (6.8%), and 25 (12.1%) for wound classes I, II, III, and IV, respectively. Median follow-up was 55.4 months (range 0.2–162.4). Overall recurrence rate was 17.4%. Contaminated cases experienced higher recurrence rates (28.8% versus 10.4%, p = 0.002) at a mean follow up of 46.9 and 60.8 months for contaminated and clean patients, respectively. Recurrent patients had higher BMI (32.4 versus 28.4 kg/m2, p = 0.0011), larger hernias (162.2 versus 106.7 cm2, p = 0.10), higher LOS (11.1 versus 5.6 days, p = 0.0051), and higher RTOR rates (16.7% versus 5.6%, p = 0.053). 51 (24.5%) patients experienced some morbidity, including 19 (9.2%) surgical site occurences, 7 (3.4%) superficial surgical site infections, 16 (7.7%) deep surgical site infections, and 1 (0.5%) organ space infection.

Conclusion

This study affirms the use of biosynthetic mesh as a cost-effective alternative in all wound classifications, yielding good outcomes, limited long-term complications, and low recurrence.

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Funding

No funding information to disclose for this project.

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Authors and Affiliations

  1. Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California, San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA

    Estella Y. Huang, Ryan C. Broderick, Graham J. Spurzem, Jonathan Z. Li, Rachel R. Blitzer, Joslin N. Cheverie, Bryan J. Sandler, Santiago Horgan & Garth R. Jacobsen

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  1. Estella Y. Huang
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  2. Ryan C. Broderick
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  3. Graham J. Spurzem
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Correspondence to Graham J. Spurzem.

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Disclosures

Broderick is a consultant for Stryker Corporation. Sandler is a consultant for Intuitive Surgical and Boston Scientific. Horgan is a consultant for Stryker Corporation, Intuitive Surgical, Fortimedix Surgical, and Alume Biosciences. Jacobsen is a consultant for Gore Medical and Viacyte. Estella Y. Huang, Graham J. Spurzem, Jonathan Z. Li, Rachel R. Blitzer, Joslin N. Cheverie have no disclosures.

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Huang, E.Y., Broderick, R.C., Spurzem, G.J. et al. Long-term outcomes of PGA-TMC absorbable synthetic scaffold in both clean and contaminated ventral hernia repairs. Surg Endosc 38, 2231–2239 (2024). https://doi.org/10.1007/s00464-024-10777-z

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