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A paradigm shift for diaphragmatic and chest wall reconstruction using a bovine acellular dermal matrix: an analysis versus synthetic meshes

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Abstract

Objectives

Recently, biologic meshes have gained increasing popularity in soft tissue reconstruction. The aim of this study was to investigate the use of a bovine acellular dermal matrix (SurgiMend, Integra LifeSciences, Princeton, NJ, USA) in diaphragmatic and chest wall reconstruction by comparing it with synthetic meshes.

Methods

Consecutive patients who underwent diaphragmatic and/or chest wall reconstruction at a single center from 2016 to 2021 were retrospectively reviewed. Outcome measures included surgical site complications, readmission, and reoperation.

Results

Sixty-six patients underwent diaphragmatic and/or chest wall reconstruction for a malignant (74.2%) or benign (25.8%) disease. SurgiMend was used in 26 (39.4%) patients and a synthetic mesh in 40 (60.6%) patients. There were no significant differences in baseline characteristics between the groups. Surgical site complications included prolonged air leak (12.1%), pleural effusion (9.1%), pneumothorax (3%), empyema (1.5%), and wound infection (1.5%). The patients in the synthetic mesh group developed a significantly higher rate of surgical site complications compared to those in the SurgiMend group (37.5% vs. 11.5%; p = 0.025). Similarly, the readmission rate was significantly higher in the synthetic mesh group (17.5% vs. 0%; p = 0.037), with causes including pleural effusion (n = 3), pneumothorax (n = 2), empyema (n = 1), and pneumonia (n = 1). Among the study cohort, only 1 patient with a synthetic mesh underwent reoperation (p > 0.99).

Conclusions

The use of surgiMend in diaphragmatic and chest wall reconstruction is associated with fewer surgical site complications and readmissions compared to synthetic meshes.

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  1. Department of Thoracic Surgery, Guy’s and St Thomas’ NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK

    Savvas Lampridis & Andrea Billè

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  1. Savvas Lampridis
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  2. Andrea Billè
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Correspondence to Savvas Lampridis.

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Lampridis, S., Billè, A. A paradigm shift for diaphragmatic and chest wall reconstruction using a bovine acellular dermal matrix: an analysis versus synthetic meshes. Gen Thorac Cardiovasc Surg 71, 121–128 (2023). https://doi.org/10.1007/s11748-022-01862-y

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  • DOI: https://doi.org/10.1007/s11748-022-01862-y

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