Claudio Birolini1, Eduardo Yassushi Tanaka2, Jocielle Santos de Miranda2, Abel Hiroshi Murakami2, Sergio Henrique Bastos Damous2, Edivaldo Massazo Utiyama2. 1. General and Trauma Surgery, Abdominal Wall and Hernia Repair Unit, Hospital das Clinicas, Department of Surgery, University of São Paulo School of Medicine, Avenida Dr. Enéas Carvalho de Aguiar, 255, 05403-010, São Paulo, Brazil. claudio.birolini@hc.fm.usp.br. 2. General and Trauma Surgery, Abdominal Wall and Hernia Repair Unit, Hospital das Clinicas, Department of Surgery, University of São Paulo School of Medicine, Avenida Dr. Enéas Carvalho de Aguiar, 255, 05403-010, São Paulo, Brazil.
Abstract
PURPOSE: The use of synthetic mesh to repair infected abdominal wall defects remains controversial. Polyvinylidene fluoride (PVDF) mesh was introduced in 2002 as an alternative to polypropylene, with the advantages of improved biostability, lowered bending stiffness, and minimum tissue response. This study aimed to evaluate the short-term outcomes of using PVDF mesh to treat infected abdominal wall defects in the elective setting. METHODS: This prospective clinical trial started in 2016 and was designed to evaluate the short- and mid-term outcomes of 38 patients submitted to abdominal wall reconstruction in the setting of active mesh infection and/or enteric fistulas (AI) when compared to a group of 38 patients submitted to clean ventral hernia repairs (CC). Patients were submitted to single-staged repairs, using onlay PVDF mesh (DynaMesh®-CICAT) reinforcement to treat their defects. RESULTS: Groups had comparable demographic characteristics. The AI group had more previous abdominal operations and required a longer operative and anesthesia time. At 30 days, surgical site occurrences were observed in 16 (42.1%) AI vs. 17 (44.7%) CC, p = 0.817; surgical site infection occurred in 4 (10.5%) AI vs. 6 (15.8%) CC, p = 0.497; and a higher number of procedural interventions were required in the CC group, 15.8 AI vs. 28.9% CC, p = 0.169. Both groups did not have chronic infections at 1 year of follow-up, and one hernia recurrence was observed in the AI group. CONCLUSIONS: The use of PVDF mesh in the infected setting presented favorable results with a low incidence of wound infection.
PURPOSE: The use of synthetic mesh to repair infected abdominal wall defects remains controversial. Polyvinylidene fluoride (PVDF) mesh was introduced in 2002 as an alternative to polypropylene, with the advantages of improved biostability, lowered bending stiffness, and minimum tissue response. This study aimed to evaluate the short-term outcomes of using PVDF mesh to treat infected abdominal wall defects in the elective setting. METHODS: This prospective clinical trial started in 2016 and was designed to evaluate the short- and mid-term outcomes of 38 patients submitted to abdominal wall reconstruction in the setting of active mesh infection and/or enteric fistulas (AI) when compared to a group of 38 patients submitted to clean ventral hernia repairs (CC). Patients were submitted to single-staged repairs, using onlay PVDF mesh (DynaMesh®-CICAT) reinforcement to treat their defects. RESULTS: Groups had comparable demographic characteristics. The AI group had more previous abdominal operations and required a longer operative and anesthesia time. At 30 days, surgical site occurrences were observed in 16 (42.1%) AI vs. 17 (44.7%) CC, p = 0.817; surgical site infection occurred in 4 (10.5%) AI vs. 6 (15.8%) CC, p = 0.497; and a higher number of procedural interventions were required in the CC group, 15.8 AI vs. 28.9% CC, p = 0.169. Both groups did not have chronic infections at 1 year of follow-up, and one hernia recurrence was observed in the AI group. CONCLUSIONS: The use of PVDF mesh in the infected setting presented favorable results with a low incidence of wound infection.
Authors: F Muysoms; G Campanelli; G G Champault; A C DeBeaux; U A Dietz; J Jeekel; U Klinge; F Köckerling; V Mandala; A Montgomery; S Morales Conde; F Puppe; R K J Simmermacher; M Śmietański; M Miserez Journal: Hernia Date: 2012-04-18 Impact factor: 4.739