Complex hernia repair using component separation technique paired with intraperitoneal acellular porcine dermis and synthetic mesh overlay.

Repairing complicated, recurrent ventral hernias poses many challenges and frustrations for both the patient and the surgeon. Patients with histories of multiple abdominal procedures, infection, and previous hernia repair are at higher risk for recurrence. They must be dealt with through a more sophisticated approach than the patient presenting with an initial hernia or even a simple recurrence. We describe our experience with 18 patients using component separation technique paired with acellular porcine dermis. We specifically focus on the use of intraperitoneal biologic mesh paired with a synthetic overlay. There were no hernia recurrences during the follow-up period: average 14 months (range, 4-24 months, 100% follow-up). Complications included seromas, wound breakdown, and infection; several of these requiring reoperation. The successful management of complicated hernias has been revolutionized by new synthetic and bioprosthetic meshes. However, these products, when used alone in complex hernia patients carry a higher recurrence rate. We have found that these meshes, used in conjunction with component separation technique, have had no recurrence to date, but are prone to complications.