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Ventral hernia repair with lateral component separation and onlay Biodesign graft

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Ventral hernia is common, complicating up to 20 % of laparotomies. Plication of the rectus sheath with lateral component separation (LCS) provides a durable repair with acceptable functional outcomes. Additional support to the anterior abdominal wall may be provided by synthetic or biological mesh. Biological grafts invoke local tissue remodeling and result in strong fibrocollagenous tissue able to support the dynamic stressor of the anterior abdominal wall. Biodesign graft is a new graft derived from porcine small-intestine submucosa. We aim to review the use of Biodesign mesh for repair of ventral hernia with LCS.

Methods

Patients underwent ventral hernia repair completed with plication of the rectus sheath, LCS, and use of an onlay Biodesign graft. Data was collected retrospectively. Key outcome measures included post-operative complications and recurrence.

Results

Twelve patients were included for analysis. Mean age was 51.2 years, with 50 % males and a median weight of 87 kg (65–111 kg). Median operative time was 210 min (147 to 278 min) and median length of stay was 4 days. At a mean follow-up of 14.0 months, 8/12 (66 %) developed seroma, 1/12 (8 %) developed abdominal wall abscess, and 1/12 (8 %) suffered flap failure requiring vacuum dressings for closure. No patients were complicated by ventral hernia recurrence.

Conclusions

Our results describe an early Australian experience of onlay Biodesign graft in the context of rectus sheath plication with LCS. We report acceptable rates of post-operative complications and recurrence.

Level of evidence: IV, therapeutic study.

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Authors and Affiliations

  1. University of Queensland, Brisbane, Australia

    Neiraja Gnaneswaran & Marlon Perera

  2. Department of Surgery, Mackay Base Hospital, Queensland Health, Bridge St, Mackay, 4740, Australia

    Marlon Perera & Ashley Jenkin

  3. Department of Surgery, The University of Melbourne, Melbourne, Australia

    Marlon Perera

  4. AAA Mackay Pathology, Mackay, QLD, Australia

    Henry Lau

  5. Mater Misercordiae Medical Centre, Mackay, QLD, Australia

    Robert Presley

  6. James Cook University, Townsville, QLD, Australia

    Robert Presley

Authors
  1. Neiraja Gnaneswaran
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  2. Marlon Perera
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  3. Ashley Jenkin
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  4. Henry Lau
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  5. Robert Presley
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Corresponding author

Correspondence to Marlon Perera.

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Ethical standards

The current study has been approved by the participating institutional ethics board. Therefore, the study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

Neiraja Gnaneswaran, Marlon Perera, Ashley Jenkin, Henry Lau, and Robert Presley declare they have no conflict of interest to disclose

Patient consent

All participants of the study provided informed consent prior to their inclusion.

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None

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Gnaneswaran, N., Perera, M., Jenkin, A. et al. Ventral hernia repair with lateral component separation and onlay Biodesign graft. Eur J Plast Surg 39, 279–286 (2016). https://doi.org/10.1007/s00238-016-1188-4

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  • DOI: https://doi.org/10.1007/s00238-016-1188-4

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