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Multicenter Study
. 2022 Oct;26(5):1241-1250.
doi: 10.1007/s10029-022-02604-y. Epub 2022 Apr 19.

Clinical outcomes of open abdominal wall reconstruction with the use of a polypropylene reinforced tissue matrix: a multicenter retrospective study

Allard S Timmer  1 , Jeroen J M Claessen  1 , Irene M Brouwer de Koning  2 , Suzanne M Haenen  1 , Eric J T Belt  3 , Antonius J N M Bastiaansen  4 , Emiel G G Verdaasdonk  2 , Carole P Wolffenbuttel  3 , Wilhelmina H Schreurs  4 , Werner A Draaisma  2 , Marja A Boermeester  5
Affiliations
Multicenter Study

Clinical outcomes of open abdominal wall reconstruction with the use of a polypropylene reinforced tissue matrix: a multicenter retrospective study

Allard S Timmer et al. Hernia. 2022 Oct.

Abstract

Objective: To assess mesh behaviour and clinical outcomes of open complex abdominal wall reconstruction (CAWR) with the use of a polypropylene reinforced tissue matrix.

Methods: A multicenter retrospective study of adult patients who underwent open CAWR with the use of a permanent polypropylene reinforced tissue matrix (OviTex®) between June 2019 and January 2021.

Results: Fifty-five consecutive patients from four hospitals in the Netherlands were analysed; 46 patients with a ventral hernia and 9 patients with an open abdomen. Most patients with a ventral hernia had one or more complicating comorbidities (91.3%) and one or more complicating hernia characteristics (95.7%). Most procedures were performed in a (clean) contaminated surgical field (69.6% CDC 2-4; 41.3% CDC 3-4). All nine patients with an open abdomen underwent semi-emergent surgery. Twelve out of 46 patients with a ventral hernia (26.1%) and 4 of 9 patients with an open abdomen (44.4%) developed a postoperative surgical site infection that made direct contact with the mesh as confirmed on computed tomography (CT), suspicious of mesh infection. No patient needed mesh explantation for persistent infection of the mesh. During a median follow-up of 13 months, 4 of 46 ventral hernia patients (8.7%) developed a CT confirmed hernia recurrence.

Conclusion: Polypropylene reinforced tissue matrix can withstand infectious complications and provides acceptable mid-term recurrence rates in this retrospective study on open complex abdominal wall reconstructions. Longer follow-up data from prospective studies are required to determine further risk of hernia recurrence.

Keywords: Abdominal wall reconstruction; Reinforced tissue matrix; Ventral hernia.

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Conflict of interest statement

A.S. Timmer, J.J.M. Claessen, I.M. Brouwer de Koning, S.M. Haenen, E.J.T. Belt, A.J.N.M. Bastiaansen, E.G.G. Verdaasdonk, C.P. Wolffenbuttel, W.H. Schreurs and W.A. Draaisma declare no conflicts of interest. M.A. Boermeester reported receiving institutional grants from J and J/Ethicon, KCI/3 M, and New Compliance; and being a speaker and/or instructor for KCI/3 M, J and J/Ethicon, BD Bard, Gore, GD Medical, Medtronic, TELABio, and Smith and Nephew.

Figures

Fig. 1
Fig. 1
Cumulative hernia recurrence rate of the patients undergoing a ventral hernia repair. During a median follow-up of 13 months the recurrence rate was 4/46 (8.7%). The median time to recurrence was 4.5 months. One of the nine patients (11.1%) that underwent closure of an open abdomen developed an incisional hernia (patients with an open abdomen are not included in this figure)
See this image and copyright information in PMC

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