One year experience of swine dermal non-crosslinked collagen prostheses for abdominal wall repairs in elective and emerg
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RESEARCH ARTICLE
WORLD JOURNAL OF EMERGENCY SURGERY
Open Access
One year experience of swine dermal noncrosslinked collagen prostheses for abdominal wall repairs in elective and emergency surgery Giulia Montori1*, Federico Coccolini1, Roberto Manfredi1, Marco Ceresoli1, Luca Campanati1, Stefano Magnone1, Michele Pisano1, Elia Poiasina1, Gabriela Nita1, Fausto Catena2 and Luca Ansaloni1
Abstract Introduction: The approach to the abdominal wall surgical repair is dramatically changed in the last years. This study evaluates our institutional outcomes about the usage of biological meshes for abdominal wall repair in different setting: in elective surgery, in emergency surgery and in abdominal wall repair following open abdomen (OA) procedure. Methods: A database was prospectively conducted (January–December 2014) and data were reviewed for patients who underwent to an abdominal wall reconstruction with swine dermal non-cross linked collagens prostheses either in elective or emergency setting, and following OA/laparostomy procedure. Demographic data, co-morbidities, indications for surgery, intra-operative details, post-operative complications and outcome (peri-operative, 3, 6, 9-months) were analyzed. Results: A total of 30 cases were reported: 9 in elective surgery (Group 1), 4 in emergency surgery (Group 2) and 17 with abdominal wall closure following OA management (Group 3). Two meshes were removed: 1 in the Group 1 and 1 in the Group 3. During follow-up only one patient in the Group 3 had a recurrence of the incisional hernia. Mortality rate was 11.1 % at 3 months in Group 1, 0 % in the Group 2, and 29.4 % in peri-operative period in the Group 3. Conclusions: The use of non-cross linked biological meshes can be safe and versatile in different situations from elective to emergency surgery, and also for the reconstruction of the abdominal wall after OA procedure, with an acceptable recurrence and mortality rate. Keywords: Biological mesh, Ventral hernia, Abdominal wall repair, Swine dermal collagen, Open abdomen, Laparostomy, Emergency surgery
Background Abdominal wall hernia is one of the most common conditions encountered by general surgeons. Procedures to repair abdominal wall defects are more than 990.000 each year in USA, with an estimated 567.000 of them performed in emergency [1, 2]. Similar data are reported in other Western countries [3]. In most cases emergency hernia repair are performed in adults over 65 years old [2]. These age-related increasing rates of emergency hernia repair are associated with increased morbidity and * Correspondence: [email protected] 1 Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy Full list of author information is available at the end of the article
mortality risks [2]. In these particular situations the use of biological materials can be safer than synthetic meshes [4]. Actually in the late 1990s, biologic materials for hernia repair were introduced as a possible biocompatible material to support “in vivo” tis
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