Repair of complex abdominal wall hernias with a cross-linked porcine acellular matrix: cross-sectional results of a Dutch cohort study
| Autor: | Lucas Timmermans, R. Kaufmann, Johan F. Lange, Yu T. van Loon, Johannes Jeekel, J.P.A.M. Vroemen |
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| Přispěvatelé: | Surgery, Neurosciences |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Swine Incisional hernia medicine.medical_treatment Cohort Studies Abdominal wall Patient satisfaction medicine Animals Humans Incisional Hernia Outpatient clinic Acellular Dermis Herniorrhaphy Aged Netherlands business.industry Postoperative complication General Medicine Middle Aged Surgical Mesh medicine.disease Hernia repair Hernia Ventral Surgery Cross-Sectional Studies Treatment Outcome medicine.anatomical_structure Abdominal examination Female business Cohort study |
| Zdroj: | International Journal of Surgery, 65, 120-127. Elsevier |
| ISSN: | 1743-9159 1743-9191 |
| Popis: | Background The use of synthetic mesh in potentially contaminated and contaminated incisional hernias may lead to a higher morbidity and mortality. Biological meshes may provide a solution, but since these meshes are rarely used, little is known about long-term results. The aim of this cohort study was to evaluate the long-term clinical efficacy and patient satisfaction following Permacol™ in complex abdominal wall hernia repair (CAWHR) patients in a cross-sectional fashion. Materials and methods All patients were operated for CAWHR with Permacol™ in the Netherlands between 2009 and 2012. The design was a multicenter cross-sectional cohort study. The STROCSS statement was followed. Patients were interviewed, underwent abdominal examination, and completed quality-of-life questionnaires. ClinicalTrials.gov Identifier NCT02166112 . Research Registry Identifier researchregistry4713. Results Seventy-seven patients were seen in the outpatient clinic. Their hernias were classified as potentially contaminated in 25 patients (32.5%) and infected in 52 patients (67.5%). The mean follow-up was 22.2 ± 12.6 months. The most frequent postoperative complication was wound infection (n = 21; 27.3%), meshes had to be removed in five patients (6.5%). By the time of their visit to the outpatient clinic, 22 patients (28.6%) had a recurrence of whom ten (13%) had undergone reoperation. Thirty-nine patients (50.6%) had bulging of the abdominal wall. Quality-of-life questionnaires revealed that patients graded their health status with a mean 6.8 (± 1.8) out of 10 points. Conclusion Bulging and recurrence are frequently observed in patients treated with Permacol™ for CAWHR. Considering both recurrence and bulging as undesirable outcomes of treatment, a total of 46 patients (59.7%) had an unfavorable outcome. Infection rates were high, but comparable with similar patient cohorts. Quality-of-life questionnaires revealed that patients were satisfied with their general health, but scored significantly lower on most quality-of-life modalities of the Short Form-36 questionnaire. |
| Databáze: | OpenAIRE |
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