Outcomes of utilizing absorbable mesh as an adjunct to posterior sheath closure during complex posterior component separation
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A minority of patients undergoing posterior component separation (PCS) have abdominal wall defects that preclude complete reconstruction of the visceral sac with native tissue. The use of absorbable mesh bridges (AMB) to span such defects has not been established. We hypothesized that AMB use during posterior sheath closure of PCS is safe and provides favorable outcomes.
We performed a retrospective review of consecutive patients undergoing PCS with AMB at two hernia centers. Main outcome measures included demographics, comorbidities, and post-operative complications.
36 patients were identified. Post-operative wound complications included five surgical site infections. At a median of 27 months, there were five recurrent hernias (13.9%), 2 of which were parastomal, but no episodes of intestinal obstruction/fistula.
Utilization of AMB for large posterior layer deficits results in acceptable rates of perioperative wound morbidity, effective PCS repairs, and does not increase intestinal morbidity or fistula formation.
KeywordsTransversus abdominis release Abdominal wall reconstruction Hernia Component separation Mesh
We would like to thank John D. Potochny, M.D. for the artwork he provided for this article.
Compliance with ethical standards
Conflict of interest
JSW, AM, and MF have no conflicts of interest to disclose. YWN is a paid consultant for C. R. Bard, Inc and Cooper Surgical, Inc and has received research support from C. R. Bard, Inc. EMP is a paid consultant for W.L. Gore & Associates, Inc, Cook Group Inc, and has received research support from Cook Group Inc and Miromatrix Medical Inc.
After receiving institutional review board approval at each of the two institutions, we performed a retrospective review of prospectively maintained databases of patients undergoing ventral hernia repair at two hernia centers (Penn State Hershey Medical Center, Hershey, PA, USA; University Hospitals Cleveland Medical Center, Cleveland, OH). We included all patients who underwent PCS from 2011 to 2015 who required an AMB for posterior layer reconstruction.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from all patients prior to all surgical procedures.
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