title: Short-term outcomes with small intestinal submucosa for ventral abdominal hernia.
abstract: OBJECTIVE
  A bioabsorbable tissue scaffold of porcine submucosal small intestine extracellular matrix (Surgisis Gold [SIS]; Cook Biotech Inc, West Lafayette, Ind) mesh is safe and effective for ventral hernia repair.
  
  
  METHODS
  Retrospective case series at a university teaching hospital.
  
  
  METHODS
  Fifty-three consecutive patients having 8-ply SIS mesh repair of ventral abdominal hernias.
  
  
  METHODS
  Early complications, reoperation, hernia recurrence, mesh or wound infection, or reaction. Outcomes reported and compared on an intention-to-treat basis.
  
  
  RESULTS
  Patients were stratified by wound class: clean, clean-contaminated and contaminated, or dirty. Median follow-up was 14 months (range, 2-29 months) during which there were 22 complications (41%), 17 early reoperations (32%), 13 partial dehiscences (21%), 6 mesh reactions (11%), and 9 recurrent hernias (17%). Seven recurrent hernias (78%) in critically ill, patients with dirty wounds had the SIS mesh removed owing to infection or reoperation. In patients without SIS mesh removal or debridement, 1 (2.2%) of 44 developed a recurrent hernia at 6 months. Patients with dirty wounds were more likely to need early reoperation (P<.001), develop a complication (P<.01), partial wound dehiscence (P<.05), or recurrent hernia (P<.01) compared with patients with clean wounds. Critically ill patients were more likely to have hernia recurrence (P<.05), early reoperation (P<.001), and postoperative complications (P<.05).
  
  
  CONCLUSIONS
  Eight-ply SIS mesh is safe in clean and clean-contaminated hernia repair with satisfactory short-term outcomes. However, delayed wound infection, repeated operation, and mesh debridement warrant cautious use of SIS mesh in critically ill patients and those with dirty wounds.
authors.affiliation: Department of Surgery, University of Illinois at Chicago, USA. scoth@uic.edu
authors.forename: W Scott
authors.initials: WS
authors.lastname: Helton
authors.forename: Piero M
authors.initials: PM
authors.lastname: Fisichella
authors.forename: Robert
authors.initials: R
authors.lastname: Berger
authors.forename: Santiago
authors.initials: S
authors.lastname: Horgan
authors.forename: Nocif Joseph
authors.initials: NJ
authors.lastname: Espat
authors.forename: Herand
authors.initials: H
authors.lastname: Abcarian
mesh_terms: D016638:Critical Illness; D003646:Debridement; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence; D013530:Surgical Wound Infection; D016896:Treatment Outcome