Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 1;3(2):e152.
doi: 10.1097/AS9.0000000000000152. eCollection 2022 Jun.

Xenogeneic Mesh Provides Safe and Durable Long-Term Outcomes in Abdominal Wall Reconstruction of High-Risk Centers for Disease Control and Prevention Class III and IV Defects

Abbas M Hassan  1 , Malke Asaad  1 , Jun Liu  1 , Anaeze C Offodile 2nd  1 , Charles E Butler  1
Affiliations

Xenogeneic Mesh Provides Safe and Durable Long-Term Outcomes in Abdominal Wall Reconstruction of High-Risk Centers for Disease Control and Prevention Class III and IV Defects

Abbas M Hassan et al. Ann Surg Open. .

Abstract

Objective: Evaluate long-term outcomes of abdominal wall reconstruction (AWR) using xenogeneic mesh in patients with Centers for Disease Control and Prevention (CDC) class III/IV defects. We hypothesized that AWR with xenogeneic mesh results in acceptable outcomes.

Background: Optimal mesh selection in AWR of CDC class III/IV defects is controversial. Outcomes using xenogeneic mesh are lacking.

Methods: We conducted a retrospective cohort study of patients who underwent AWR using xenogeneic mesh in CDC class III/IV defects from March 2005 to June 2019. Primary outcome was hernia recurrence (HR). Secondary outcomes were surgical site occurrence (SSO) and surgical site infection (SSI).

Results: Of consecutive 725 AWRs, we identified 101 patients who met study criteria. Sixty-eight patients had class III defects, while 33 had class IV defects. Patients had a mean age of 61.3 ± 11.1 years, mean body mass index of 31.8 ± 7.3 kg/m2, and mean follow-up time of 41.9 ± 26.3 months. Patients had HR rate of 21%, SSO rate of 49%, and SSI rate of 24. Class IV defects were predictive of SSOs (odds ratio [OR], 2.88; 95% confidence interval [CI], 1.11-7.42; P = 0.029) but not HR (hazard ratio, 1.60; 95% CI, 0.59-4.34; P = 0.355) or SSIs (OR, 2.62; 95% CI, 0.85-8.10; P = 0.094).

Conclusions: Patients with class IV defects have a higher risk of SSOs, but not HR or SSIs, compared with patients with class III defects. Despite the high level of defect contamination, AWR with xenogeneic mesh demonstrated acceptable HR, SSO, and SSI rates. Therefore, safe and durable long-term outcomes are achievable in single-stage AWR using xenogeneic mesh for CDC class III/IV defects.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.
Kaplan–Meier curve for hernia recurrence.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Poulose BK, Shelton J, Phillips S, et al. . Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012;16:179–183. - PubMed
    1. Asaad M, Kapur SK, Baumann DP, et al. . Acellular dermal matrix provides durable long-term outcomes in abdominal wall reconstruction: a study of patients with over 60 months of follow-up [published online ahead of print October 19, 2020]. Ann Surg. doi: 10.1097/SLA.0000000000004454. - PubMed
    1. Breuing K, Butler CE, Ferzoco S, et al. . Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery. 2010;148:544–558. - PubMed
    1. Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg. 2002;89:534–545. - PubMed
    1. Ortega G, Rhee DS, Papandria DJ, et al. . An evaluation of surgical site infections by wound classification system using the ACS-NSQIP. J Surg Res. 2012;174:33–38. - PubMed