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Abdominal wall reconstruction with large polypropylene mesh: is bigger better?
- Source :
- Hernia. 23:1003-1008
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- 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. 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. 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. 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.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
030230 surgery
Polypropylenes
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
medicine
Electronic Health Records
Humans
Hernia
Herniorrhaphy
Retrospective Studies
business.industry
Abdominal Wall
Abdominoplasty
Abdominal wall reconstruction
Prolene mesh
Retrospective cohort study
Middle Aged
Surgical Mesh
Hernia repair
medicine.disease
Hernia, Ventral
Surgery
Polypropylene mesh
Outcome and Process Assessment, Health Care
030220 oncology & carcinogenesis
Seroma
Female
business
Abdominal surgery
Subjects
Details
- ISSN :
- 12489204 and 12654906
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Hernia
- Accession number :
- edsair.doi.dedup.....dd08531cf059d913d07e23eb23493e4a