当前位置： SCI文献检索 > SURGERY期刊下所有文献 > Biologic mesh in ventral hernia repair: Outcomes, recurrence, and charge analysis.

Biologic mesh in ventral hernia repair: Outcomes, recurrence, and charge analysis.

Abstract：

BACKGROUND:Biologic mesh choice in ventral hernia repair is challenging due to lack of prospective data. This study examines long-term, single-center biologic mesh outcomes. METHODS:Prospective operative outcomes data was queried for open ventral hernia repair with biologic mesh. Univariate and multivariate analysis were used to compare mesh outcomes. RESULTS:In the study, 223 patients underwent open ventral hernia repair with biologic mesh, including 40 with Alloderm, 23 AlloMax, 70 FlexHD, 68 Strattice, and 22 Xenmatrix. Overall, 9.8% had an American Society of Anesthesiology classification of 4, 54.6% with a classification of 3, and 35.6% with a classification of 1 or 2. Operative time averaged 241 minutes with estimated blood loss of 202 mL. Hernia defects averaged 257 ± 245 cm2 with mesh size 384 cm2. Biologic mesh was used as a fascial bridge in 19.6%, component separation was performed in 47.5%, and 82% had concomitant procedure. Inpatient mortality was 1.4%. Hernia recurrence varied significantly by mesh type: 35% Alloderm, 34.5% AlloMax, 37.1% FlexHD, 14.7% Strattice, and 59.1% Xenmatrix (P = .001). The mean follow-up was 18.2 months. After multivariate analysis comparing to Strattice, AlloMax had a 3.4 higher odds ratio for recurrence, FlexHD a 2.9 odds ratio, and Xenmatrix a 7.8 odds ratio. The rate of mesh infections requiring explantation was <1%. Total hospital charges averaged $131,004 ± $143,320. Mean charges varied significantly between meshes; Xenmatrix was the most expensive and AlloMax was the least expensive (P < .05). CONCLUSION:In 223 ventral hernia repair performed with biologic mesh at a tertiary care institution, Strattice, a porcine acellular dermal mesh, had significantly lower odds of hernia recurrence compared with AlloMax, FlexHD, and Xenmatrix. Choice of biologic mesh affects long-term postoperative outcomes in ventral hernia repair.

journal_name

Surgery

journal_title

Surgery

authors

Huntington CR,Cox TC,Blair LJ,Schell S,Randolph D,Prasad T,Lincourt A,Heniford BT,Augenstein VA

doi

10.1016/j.surg.2016.07.008

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

1517-1527

issue

eissn

0039-6060

issn

1532-7361

pii

S0039-6060(16)30340-3

journal_volume

160

pub_type

杂志文章

在线工具

Biologic mesh in ventral hernia repair: Outcomes, recurrence, and charge analysis.