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

Abdominal wall reconstruction with large polypropylene mesh: is bigger better? 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 accom- plished 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 under- went 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), http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Hernia Springer Journals

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

Hernia, Volume 23 (5) – Aug 30, 2019

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Publisher
Springer Journals
Copyright
Copyright © 2019 by Springer-Verlag France SAS, part of Springer Nature
Subject
Medicine & Public Health; Abdominal Surgery
ISSN
1265-4906
eISSN
1248-9204
DOI
10.1007/s10029-019-02026-3
Publisher site
See Article on Publisher Site

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 accom- plished 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 under- went 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),

Journal

HerniaSpringer Journals

Published: Aug 30, 2019

References

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