Abdominal wall reconstruction with large polypropylene mesh: is bigger better?

M. Nisiewicz, T. Hughes, M. A. Plymale, D. L. Davenport, J. S. Roth

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: Hernia repair for large and complex hernias presents challenges related to the availability of larger mesh sizes. When sizes beyond those manufactured are required, multiple meshes (MM) may be sutured to create a larger graft. With the availability of large polypropylene mesh up to 50 × 50 cm (LM), abdominal wall reconstruction (AWR) may be accomplished with a single mesh. This study evaluates clinical and economic outcomes following AWR with component separation utilizing MM and LM. Methods: A retrospective study was performed with review of health records and cost accounting data. Patients that underwent AWR with LM were case matched 1:1 with patients undergoing MM repair based upon comorbidities, defect size and wound class. Results: Twenty-four patients underwent AWR with LM. Twenty patients (10F, 10 M) who underwent AWR with LM were matched with 20 MM AWR (11F, 9 M). Age, BMI, ASA 3 + , never smoker, diabetes, and hernia characteristics were similar between LM and MM. Operative cost ($4295 vs $3669, p = 0.127), operative time (259 min vs 243 min, p = 0.817), length of stay (5.5 vs 6.2, p = 0.484), wound complication (30% vs 20%, p = 0.716), infected seroma (5% vs 5%, p = 1), and readmission (5% vs 15%, p = 0.605) were similar between LM and MM, respectively. Conclusions: This is the first report of patients undergoing AWR with a large 50 × 50 cm prolene mesh. In this small cohort, clinical outcomes were similar between those undergoing repair with multiple sutured mesh sheets and a single large mesh.

Original languageEnglish
Pages (from-to)1003-1008
Number of pages6
JournalHernia
Volume23
Issue number5
DOIs
StatePublished - Oct 1 2019

Bibliographical note

Funding Information:
Authors MN, TH, MP, DP report no conflict of interest related to this study. JR has received grant funding from Becton Dickinson/CR Bard, is a consultant for Becton Dickinson/CR Bard, Allergan, and Johnson and Johnson and is a shareholder with Miromatrix.

Publisher Copyright:
© 2019, Springer-Verlag France SAS, part of Springer Nature.

Keywords

  • Abdominal wall reconstruction
  • Hospital costs
  • Loss of domain
  • Multiple mesh pieces
  • Prolene mesh

ASJC Scopus subject areas

  • Surgery

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