title: Ventral hernia repair after bowel surgery: does gastrointestinal contamination matter in the era of biologic mesh?
abstract: BACKGROUND
  Ventral hernias are often repaired after planned or unplanned bowel procedures. Biologic materials are thought to better tolerate gastrointestinal contamination than synthetic alternatives. The purpose of this review was to evaluate the impact of intestinal contamination on ventral hernia repair with biologic material.
  
  
  METHODS
  This is a retrospective review of all patients who underwent ventral hernia repair with biologic material between 2003 and 2012. Groups were defined based on performance of concomitant bowel surgery. Data were collected on patient demographics, risk factors, concomitant procedures, mesh type, and outcomes.
  
  
  RESULTS
  Of 82 patients included in this series, 32 (39%) had concomitant bowel surgery. Ventral hernia repair was performed predominantly with Alloderm and Strattice. There was no difference in hernia recurrence (contaminated group-28% vs. non-contaminated group-34%, P = 0.58), surgical site infections (contaminated-28% vs. non-contaminated-20%, P = 0.40), or other complications when patients with and without concomitant bowel surgery were compared.
  
  
  CONCLUSIONS
  Biologic materials have made it such that ventral hernias can be safely repaired after bowel surgery without increased risk of complications.
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, GA.
authors.forename: Ximena A
authors.initials: XA
authors.lastname: Pinell-White
authors.forename: Mark
authors.initials: M
authors.lastname: Gruszynski
authors.forename: Albert
authors.initials: A
authors.lastname: Losken
mesh_terms: D003094:Collagen; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D014945:Wound Healing
chemical_list: C440568:Alloderm; C568444:strattice; D003094:Collagen