Single institutional experience using biological mesh for abdominal wall reconstruction.
BACKGROUND
Complex ventral hernias remain a challenge. We present a study evaluating outcomes of complex ventral hernia repair using human-derived acellular dermal matrix (AlloDerm) and porcine-derived acellular dermal sheet (Permacol).


METHODS
A retrospective review of 251 patients undergoing complex hernia repair was performed. Primary outcome was hernia recurrence; and secondary outcomes included early and late complications and mortality.


RESULTS
Recurrence for Permacol versus AlloDerm was 32% versus 47% (P = .02). There was a difference in early complications (48% vs 30%, P = .007) and also late complications (30% vs 21%, P = .16) of Permacol versus AlloDerm. Overall survival was 85% for the Permacol group versus 78% for the AlloDerm group (P = .23). Recurrence for Permacol versus AlloDerm for underlay technique was 19% versus 22% and that for bridging technique was 44% versus 57%.


CONCLUSIONS
There exists a high complication rate from both Permacol and AlloDerm in complex ventral hernia repair especially when used as a fascial bridge.
Department of Surgery, William Beaumont Hospital System, Oakland University, Royal Oak, MI, USA. Electronic address: anthony.iacco@beaumont.edu.
Anthony
A
Iacco
Department of Surgery, William Beaumont Hospital System, Oakland University, Royal Oak, MI, USA.
Adewunmi
A
Adeyemo
Department of Surgery, William Beaumont Hospital System, Oakland University, Royal Oak, MI, USA.
Thomas
T
Riggs
Department of Surgery, William Beaumont Hospital System, Oakland University, Royal Oak, MI, USA.
Randy
R
Janczyk
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D003094:Collagen; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
C440568:Alloderm; C422414:Permacol; D003094:Collagen
Abdominal wall; Biologic; Hernia; Mesh; Ventral hernia