Absorbable Polyglactin vs. Non-Cross-linked Porcine Biological Mesh for the Surgical Treatment of Infected Incisional Hernia

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TitreAbsorbable Polyglactin vs. Non-Cross-linked Porcine Biological Mesh for the Surgical Treatment of Infected Incisional Hernia
Type de publicationJournal Article
Year of Publication2020
AuteursRenard Y, de Mestier L, Henriques J, de Boissieu P, de Mestier P, Fingerhut A, Palot J-P, Kianmanesh R
JournalJOURNAL OF GASTROINTESTINAL SURGERY
Volume24
Pagination435-443
Date PublishedFEB
Type of ArticleArticle
ISSN1091-255X
Mots-clésAcellular dermis, Collagen, epidemiology, Extracellular matrix, Hernia, Herniorrhaphy, Methods, prevention and control, Surgery, Surgical mesh, Surgical wound infection, therapeutic use, Ventral, Wound healing
Résumé

{Background The use of absorbable meshes during contaminated or infected incisional hernia (IH) repair is associated with high morbidity and recurrence rates. Biological meshes might be more appropriate but have been described in highly heterogeneous series. This study aimed at comparing the efficacy of absorbable vs. biological meshes for the treatment of contaminated or infected IH in a homogeneous series with a standardized technique. Methods Data of all patients operated on between 2008 and 2015 for contaminated or infected IH, using an absorbable (A) Vicryl (R) or a biological (B) Strattice (R) mesh, were reviewed. Patient characteristics, infectious complication rates, and recurrence-free outcome (RFO) were compared between the two groups. A propensity score methodology was applied to a Cox regression model to deal with unbalanced characteristics between groups. Results Patient demographics in A (n = 57) and in B (n = 24) were similar except that B patients had larger parietal defects (p < 0.001) and higher Center for Disease Control (CDC) wound class (p = 0.034). Patients in A had statistically significantly more postoperative early (61.4% vs. 33.3%

DOI10.1007/s11605-018-04095-8