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Ventral herniorrhaphy in contaminated operative fields using Permacol mesh

Argo JLA, Hawn MT. Ventral herniorrhaphy in contaminated operative fields using Permacol mesh. Poster session presented at: Southeastern Surgical Annual Congress; 2008 Feb 1; Birmingham, AL.

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Ventral herniorrhaphy in contaminated operative fields using Permacol mesh JL Argo, MD; MT Hawn, MD, MPH; JD Christein, MD; CC Vick, MS; ER Drelichman, MD; University of Alabama at Birmingham Department of Surgery, Section of Gastrointestinal Surgery Poster presentation ath the Southeastern Surgical Congress (SESC) Annual Meeting, February 2008, Birmingham AL BACKGROUND: Repair of ventral hernias in contaminated fields is challenging because of the high risk of infection when synthetic graft is used. It has been suggested that biosynthetic grafts can decrease risk of complications and result in long term hernia repair. The goal of this study is to evaluate the use of Permacol, a cross-linked porcine dermal collagen mesh, in contaminated ventral hernia fields. METHODS: The charts of 11 patients who underwent 12 ventral hernia repairs with Permacol mesh in contaminated fields were reviewed in this retrospective study. Comorbidities including obesity, smoking, COPD, diabetes, and liver disease and complications were evaluated. RESULTS: The mean age of the population was 49 years (28-75yrs). Wound complications were experienced by 100% and included seroma (8.0%), infection (50.0%), and recurrence (50.0%). Operative drainage was required in five cases (83%) complicated by infection. Mean follow-up was 14.3 months (2-32 months). There was no difference in complications based on comorbid status (90% without vs. 100.0% with comorbidities, p = 1.0). DISCUSSION: When used in a contaminated field, Permacol mesh has a high rate of complications and recurrence. Further research and development are necessary to develop a biologic graft material that can succeed in contaminated fields.

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