دورية أكاديمية
Outcomes of mid-term and long-term degradable biosynthetic meshes in single-stage open complex abdominal wall reconstruction.
| العنوان: | Outcomes of mid-term and long-term degradable biosynthetic meshes in single-stage open complex abdominal wall reconstruction. |
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| المؤلفون: | Claessen JJM; Department of Surgery, Amsterdam Gastroenterology and Metabolism, Infection and Immunity, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands., Timmer AS; Department of Surgery, Amsterdam Gastroenterology and Metabolism, Infection and Immunity, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands., Atema JJ; Department of Surgery, Amsterdam Gastroenterology and Metabolism, Infection and Immunity, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands., Boermeester MA; Department of Surgery, Amsterdam Gastroenterology and Metabolism, Infection and Immunity, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands. m.a.boermeester@amsterdamumc.nl. |
| المصدر: | Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2021 Dec; Vol. 25 (6), pp. 1647-1657. Date of Electronic Publication: 2021 Jun 07. |
| نوع المنشور: | Journal Article; Observational Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: France NLM ID: 9715168 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1248-9204 (Electronic) Linking ISSN: 12489204 NLM ISO Abbreviation: Hernia Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Paris, France : Springer, c1997- |
| مواضيع طبية MeSH: | Abdominal Wall*/surgery , Hernia, Ventral*/etiology, Herniorrhaphy/adverse effects ; Humans ; Recurrence ; Retrospective Studies ; Surgical Mesh/adverse effects ; Surgical Wound Infection/etiology ; Surgical Wound Infection/surgery ; Treatment Outcome |
| مستخلص: | Objective: To assess clinical outcomes in patients that underwent open single-stage complex abdominal wall reconstruction (CAWR) with biosynthetic mesh. Methods: Retrospective observational study of two prospectively registered series of consecutive patients undergoing CAWR with either long-term degradable (LTD) Phasix ™ or mid-term degradable (MTD) BIO-A ® biosynthetic mesh in a single institution between June 2016 and December 2019. Results: From 169 patients with CAWR, 70 consecutive patients were identified who underwent CAWR with either LTD or MTD biosynthetic mesh. More than 85% of patients had an incisional hernia that could be classified as moderately complex to major complex due to a previous wound infection (67%), one or more complicating comorbidities (87.1%), one or more complicating hernia characteristics (75.7%) or contaminated or dirty defects (37.1%). Concomitant component separation was performed in 43 of 70 patients (61.4%). Overall surgical site infection (SSI) rate in these CAWR patients was 45.7%. Seventeen of 70 patients (24.3%) had computed tomography (CT) - and culture-confirmed SSI in direct contact of mesh, suspicious of mesh infection. Mesh removal for persistent local infection occurred in 10% (7 of 70) after a median of 229 days since surgery. Salvage rate of mesh after direct contact with infection was 58.8%. All removed meshes were in the LTD group. Seven patients (10%) had a recurrence; four patients in the LTD group (10%) had a recurrence at a median follow-up of 35 months and three patients in the MTD group (10%) at a median follow-up of 11 months. Three of the seven recurrences occurred in patients with SSI in persistent and direct contact with mesh. Conclusions: Comorbid patients undergoing open complex abdominal wall reconstruction are at high risk of postoperative wound complications regardless of which type of biosynthetic mesh is used. When in persistent and direct contact with infection, long-term biodegradable biosynthetic meshes may need to be removed, whereas mid-term biodegradable biosynthetic meshes can be salvaged. (© 2021. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Bio-A; Biosynthetic mesh; CAWR; Phasix; long-term degradable; mid-term degradable |
| تواريخ الأحداث: | Date Created: 20210607 Date Completed: 20220408 Latest Revision: 20220428 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC8182350 |
| DOI: | 10.1007/s10029-021-02415-7 |
| PMID: | 34097187 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1248-9204 |
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| DOI: | 10.1007/s10029-021-02415-7 |