title: Use of composite grafts in abdominal sacrocolpopexy.
abstract: OBJECTIVE
  : The ideal graft material for pelvic reconstructive surgery remains undetermined. The purpose of this study was to present data on novel composite biologic/synthetic grafts during use in abdominal sacrocolpopexy.
  
  
  METHODS
  : A case series of 90 patients undergoing abdominal sacrocolpopexy with composite biologic/synthetic grafts was conducted. The primary outcome was graft erosion. Assuming a 3% risk of reoperation for mesh erosion, the number needed to treat with a composite graft in order to avoid erosion risk from a synthetic-only graft was calculated. The cost of a composite graft was compared to reoperation costs for mesh erosion of a synthetic-only graft.
  
  
  RESULTS
  : Zero patients (N = 90) undergoing abdominal sacrocolpopexy with a composite biologic/synthetic graft experienced graft erosion. Based on existing data, thirty-three patients would need to be treated with a composite graft to avoid one mesh erosion from a synthetic-only graft. If a $500 composite graft is used, the cost of reoperation performed abdominally is higher.
  
  
  CONCLUSIONS
  : This study introduces a novel biologic/synthetic composite graft that offers the advantage of low erosion risk during use in abdominal sacrocolpopexy. Combined grafts may also be cost-effective. Future research should focus on exploring the role of these durable, yet low erosion risk grafts to potentially promote improved safety for our patients and cost savings for society.
authors.affiliation: From the *Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA; and †Division of Urogynecology, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, CA.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Skoczylas
authors.forename: Felicia L
authors.initials: FL
authors.lastname: Lane
authors.forename: Karen L
authors.initials: KL
authors.lastname: Noblett