Hernia Research Today is a free monthly online journal that collates and summarizes the latest research about Hernia, including details on hiatal, inguinal, umbilical, abdominal, treatment.

Short-term outcomes with small intestinal submucosa for ventral abdominal hernia.

Helton WS, Fisichella PM, Berger R, Horgan S, Espat NJ, Abcarian H

Department of Surgery, University of Illinois at Chicago, USA. scoth@uic.edu

HYPOTHESIS: A bioabsorbable tissue scaffold of porcine submucosal small intestine extracellular matrix (Surgisis Gold [SIS]; Cook Biotech Inc, West Lafayette, Ind) mesh is safe and effective for ventral hernia repair. DESIGN: Retrospective case series at a university teaching hospital. PATIENTS: Fifty-three consecutive patients having 8-ply SIS mesh repair of ventral abdominal hernias. MAIN OUTCOME MEASURES: Early complications, reoperation, hernia recurrence, mesh or wound infection, or reaction. Outcomes reported and compared on an intention-to-treat basis. RESULTS: Patients were stratified by wound class: clean, clean-contaminated and contaminated, or dirty. Median follow-up was 14 months (range, 2-29 months) during which there were 22 complications (41%), 17 early reoperations (32%), 13 partial dehiscences (21%), 6 mesh reactions (11%), and 9 recurrent hernias (17%). Seven recurrent hernias (78%) in critically ill, patients with dirty wounds had the SIS mesh removed owing to infection or reoperation. In patients without SIS mesh removal or debridement, 1 (2.2%) of 44 developed a recurrent hernia at 6 months. Patients with dirty wounds were more likely to need early reoperation (P<.001), develop a complication (P<.01), partial wound dehiscence (P<.05), or recurrent hernia (P<.01) compared with patients with clean wounds. Critically ill patients were more likely to have hernia recurrence (P<.05), early reoperation (P<.001), and postoperative complications (P<.05). CONCLUSIONS: Eight-ply SIS mesh is safe in clean and clean-contaminated hernia repair with satisfactory short-term outcomes. However, delayed wound infection, repeated operation, and mesh debridement warrant cautious use of SIS mesh in critically ill patients and those with dirty wounds.

Published 21 June 2005 in Arch Surg, 140(6): 549-60; discussion 560-2.
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