title: Impact of mesh use on morbidity following ventral hernia repair with a simultaneous bowel resection.
abstract: OBJECTIVE
  To evaluate the impact of mesh use on outcomes following ventral hernia repairs and simultaneous bowel resection.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Teaching academic hospital.
  
  
  METHODS
  We studied 177 patients who underwent a ventral hernia repair with a bowel resection between May 1, 1992, and May 30, 2007. A prosthesis was used in 51 repairs (mesh group), while 126 repairs were primary (mesh-free group).
  
  
  METHODS
  Demographic characteristics, comorbidities, mesh type, bowel resection type (colon vs small bowel), defect size, drain use, and length of hospital stay were compared between groups with Fisher exact test and multivariate analysis.
  
  
  RESULTS
  There were no statistically significant differences between patient characteristics and relevant comorbidities. The incidence of postoperative infection (superficial or deep) was 22% in the mesh group vs 5% in the mesh-free group (P = .001). Other complications (fistula, seroma, hematoma, bowel obstruction) occurred in 24% of patients in the mesh group vs 8% of patients in the mesh-free group (P = .009). Focusing on the patients who developed an infection, prosthetic mesh use was the only significant risk factor on multivariate regression analysis, irrespective of drain use, defect size, and type of bowel resection.
  
  
  CONCLUSIONS
  We recommend caution in using mesh when performing a ventral hernia repair with a simultaneous bowel resection because of significantly increased postoperative infectious complications. Drain use, defect size, and bowel resection type did not influence outcomes.
authors: Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
authors: Dimitrios
authors: D
authors: Xourafas
authors: Stuart R
authors: SR
authors: Lipsitz
authors: Paolo
authors: P
authors: Negro
authors: Stanley W
authors: SW
authors: Ashley
authors: Ali
authors: A
authors: Tavakkolizadeh
mesh_terms: D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000601:surgery; D007414:Intestinal Neoplasms / Q000453:epidemiology / Q000601:surgery; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome