An evaluation of clinical and quality of life outcomes after ventral hernia repair with poly-4-hydroxybutyrate mesh.

Autor: Christopher AN; Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Penn Presbyterian Hospital, 51 North 39th Street, Wright Saunders Building, Philadelphia, PA, 19104, USA.; Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA., Morris MP; Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Penn Presbyterian Hospital, 51 North 39th Street, Wright Saunders Building, Philadelphia, PA, 19104, USA., Patel V; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Mellia JA; Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Penn Presbyterian Hospital, 51 North 39th Street, Wright Saunders Building, Philadelphia, PA, 19104, USA., Fowler C; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Messa CA 4th; H. Wayne Huizenga School of Business and Entrepreneurship, Nova Southeastern University, Davie, FL, USA., Broach RB; Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Penn Presbyterian Hospital, 51 North 39th Street, Wright Saunders Building, Philadelphia, PA, 19104, USA., Fischer JP; Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Penn Presbyterian Hospital, 51 North 39th Street, Wright Saunders Building, Philadelphia, PA, 19104, USA. john.fischer2@pennmedicine.upenn.edu.
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2021 Jun; Vol. 25 (3), pp. 717-726. Date of Electronic Publication: 2021 Apr 27.
DOI: 10.1007/s10029-021-02394-9
Abstrakt: Purpose: Despite continued efforts, recurrence after ventral hernia repair (VHR) remains a common problem. Biosynthetic Phasix ™ (Poly-4-Hydroxybutyrate, P4HB) mesh combines the durability of synthetic mesh with the bio-resistance of biologics. P4HB has shown promising early outcomes, but long-term data are lacking. We examine patients following VHR with P4HB with at least 3 years of follow-up to assess clinical and patient reported outcomes (PROs).
Methods: Adult patients (≥ 18 years old) undergoing VHR with P4HB mesh between 10/2015 and 01/2018 by a single surgeon were retrospectively identified. Patients with < 36 months of follow-up were excluded unless they had a documented recurrence. Clinical outcomes and quality of life using the Hernia-Related Quality of Life Survey (HerQLes) were assessed.
Results: Seventy-one patients were included with a median age and body mass index of 61.2 and 31 kg/m 2 , respectively. Mesh was placed in the retromuscular (79%) and onlay (21%) planes with 1/3 of patients having hernias repaired in contaminated fields. There were no mesh infections, enterocutaneous fistulas, or mesh explantations. Nine patients (12.7%) developed recurrence at a median follow-up of 43.1 months [38.2-49.1]. Mesh plane, fixation technique, and Ventral Hernia Working Group were not associated with recurrence. Significant improvement in disease-specific PROs was observed and maintained at 3-year follow-up.
Conclusion: Longitudinal clinical and quality of life outcomes after clean and contaminated VHR with P4HB are limited. Here, we conclude that P4HB is an effective and versatile mesh option for use in abdominal wall reinforcement.
Databáze: MEDLINE
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