World Journal of Surgery

, Volume 36, Issue 8, pp 1760–1764 | Cite as

A Preliminary Comparison Study of Two Noncrosslinked Biologic Meshes Used in Complex Ventral Hernia Repairs

  • Mona Janfaza
  • Maureen Martin
  • Ruby SkinnerEmail author



The biologic materials currently available for hernia repairs are costly and there are limited statistics on recurrences and rates of infection in connection with their use in complex cases.


We performed a retrospective review and comparison of two types of biologic mesh used at our institution for abdominal hernia repairs spanning a 1-year period. Demographic data and outcomes relating to surgical site infections, hernia recurrences, and mortality were analyzed. Of the 35 patients in the study, 23 patients (Group I) were managed with SurgiMend, a neonatal bovine mesh, and 12 patients (Group II) were managed with Flex HD, a human-derived mesh.


The study cohorts met criteria for high-risk stratification based on body mass index, comorbid conditions, and a high prevalence of contaminated wounds. The overall surgical site infection rate was 17 % for Group I and 50 % for Group II. These differences reached statistical significance when comparing superficial infections but not for deep infections with mesh involvement. Hernia recurrences in Group I were 5 % compared to 33 % in Group II. No deaths were observed.


These preliminary data demonstrate promising short-term outcomes for high-risk complex hernias repaired with biologic mesh, particularly SurgiMend, but the long-term durability of these biological materials is yet to be determined.


Hernia Repair Hernia Recurrence Ventral Hernia Repair Open Abdomen Abdominal Wall Hernia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors declare that they have no competing interest and nothing to disclose.


  1. 1.
    Fabian TC (2007) Damage control in trauma: laparotomy wound management acute to chronic. Surg Clin North Am 87:73–93PubMedCrossRefGoogle Scholar
  2. 2.
    Hirsch EF (2004) Repair of an abdominal wall defect after a salvage laparotomy for sepsis. J Am Coll Surg 198:324–328PubMedCrossRefGoogle Scholar
  3. 3.
    Bachman S, Ramshaw B (2008) Prosthetic mesh in ventral hernia repair: how do I choose? Surg Clin North Am 88:101–112PubMedCrossRefGoogle Scholar
  4. 4.
    Hiles M, Ritchie R, Altizer A (2009) Are biologic grafts effective for hernia repairs? a systematic review of the literature. Surg Innov 16(1):26–37PubMedCrossRefGoogle Scholar
  5. 5.
    Rosen M (2010) Biologic mesh for abdominal wall reconstruction: a critical appraisal. Am Surg 76(1):1–6PubMedGoogle Scholar
  6. 6.
    Volyes CR, Richardson JD, Bland KI et al (1981) Emergency abdominal wall reconstruction with polypropylene mesh: short-term benefits versus long-term outcomes. Ann Surg 194(2):219–223CrossRefGoogle Scholar
  7. 7.
    Bleichrodt RD (1993) Expanded polyterafluoroethylene patch versus polyprolene mesh for the repair of contaminated defects of the abdominal wall. Surg Gynecol Obstet 176(1):18–24PubMedGoogle Scholar
  8. 8.
    Xourafas D, Lipsitz S, Negro P et al (2010) Impact of mesh use on morbidity following ventral hernia repair with a simultaneous bowel resection. Arch Surg 145(8):739–744PubMedCrossRefGoogle Scholar
  9. 9.
    Basoglu M, Yildirgan M, Yilmaz I et al (2004) Late complications of incisional hernias following prosthetic mesh repair. Acta Chir Belg 104(4):425–428PubMedGoogle Scholar
  10. 10.
    Rose J, Jayaraman S, Colquhoun P et al (2009) Minimal abdominal adhesions after sepramesh repair of a parastomal hernia. Can J Surg 52(5):E211–E212PubMedGoogle Scholar
  11. 11.
    Pierce R, Perrone J, Nimeri A et al (2009) 120-Day comparative analysis of adhesion grade and quantity, mesh contraction, and tissue response to a novel omega-3 fatty acid bioabsorbable barrier macroporous mesh after intraperitoneal placement. Surg Innov 16(1):46–54PubMedCrossRefGoogle Scholar
  12. 12.
    Cavallaro A, Lo Menzo E, Zanghi A et al (2010) Use of biological meshes for abdominal wall reconstruction in highly contaminated fields. World J Gastroenterol 16(15):1928–1933PubMedCrossRefGoogle Scholar
  13. 13.
    Diaz J, Conquest A, Ferzoco S et al (2009) Multi-institutional experience using human acellular dermal matrix for ventral hernia repair in a compromised surgical field. Arch Surg 144(3):209–215PubMedCrossRefGoogle Scholar
  14. 14.
    Bellows CF, Albo D, Berger DH et al (2007) Abdominal wall repair using human acellular dermis. Am J Surg 194(2):192–198PubMedCrossRefGoogle Scholar
  15. 15.
    Awad SS (2009) Microbiology of infected acellular dermal matrix (AlloDerm) in patients requiring complex abdominal closure after emergency surgery. Surg Infect (Larchmt) 10(1):79–84CrossRefGoogle Scholar
  16. 16.
    Jin J, Rosen MJ, Blatnik J et al (2007) Use of acellular dermal matrix for complicated ventral hernia repair: does technique affect outcomes? J Am Coll Surg 205(5):654–660PubMedCrossRefGoogle Scholar
  17. 17.
    van Geffen HJ, Simmermacher RK, van Vroonhoven TJ et al (2005) Surgical treatment of large contaminated abdominal wall defects. J Am Coll Surg 201(2):206–212PubMedCrossRefGoogle Scholar
  18. 18.
    Butler CE, Burns NK, Campbell KT et al (2010) Comparison of cross-linked and non-cross-linked porcine acellular dermal matrices for ventral hernia repair. J Am Coll Surg 211(3):368–376PubMedCrossRefGoogle Scholar
  19. 19.
    Butler CE (2006) The role of bioprosthetics in abdominal wall reconstruction. Clin Plast Surg 33:199–211PubMedCrossRefGoogle Scholar
  20. 20.
    Orenstein S, Qiao Y, Kaur M et al (2010) In vitro activation of human peripheral blood mononuclear cells induced by human biologic meshes. J Surg Res 158:10–14PubMedCrossRefGoogle Scholar
  21. 21.
    Teller P, White TK (2009) The physiology of wound healing: injury through maturation. Surg Clin North Am 89(3):599–610PubMedCrossRefGoogle Scholar
  22. 22.
    Byrnes MC, Irwin E, Carlson D et al (2011) Repair of high-risk incisional hernias and traumatic abdominal wall defects with porcine mesh. Am Surg 77:144–150PubMedGoogle Scholar
  23. 23.
    Limpert JN, Desai AR, Kumf AL et al (2009) Repair of abdominal wall defects with bovine pericardium. Am J Surg 198:60–65CrossRefGoogle Scholar
  24. 24.
    Rosen MJ, Reynolds HL, Champagne B, Delaney CP (2010) A novel approach for the simultaneous repair of large midline incisional and parastomal hernias with biological mesh and retrorectus reconstruction. Am J Surg 199:416–420PubMedCrossRefGoogle Scholar
  25. 25.
    Blatnik J, Jin J, Rosen M (2008) Abdominal hernia repair with bridging acellular dermal matrix—an expensive hernia sac. Am J Surg 196(1):47–50PubMedCrossRefGoogle Scholar
  26. 26.
    Candage R, Jones K, Luchette FA et al (2008) Use of human acellular dermal matrix for hernia repair: friend of foe? Surgery 144(4):703–711PubMedCrossRefGoogle Scholar
  27. 27.
    Pomahac B, Aflaki P (2010) Use of a non-cross-linked porcine dermal scaffold in abdominal wall reconstruction. Am J Surg 199(1):22–27PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  1. 1.Department of SurgeryKern Medical CenterBakersfieldUSA

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