Sivaraj Dharshan, Henn Dominic, Fischer Katharina S, Kim Trudy S, Black Cara K, Lin John Q, Barrera Janos A, Leeolou Melissa C, Makarewicz Nathan S, Chen Kellen, Perrault David P, Gurtner Geoffrey C, Lee Gordon K, Nazerali Rahim
Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif.
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex.
Plast Reconstr Surg Glob Open. 2022 Feb 7;10(2):e4083. doi: 10.1097/GOX.0000000000004083. eCollection 2022 Feb.
The use of biologic mesh to reinforce the abdominal wall in ventral hernia repair has been proposed as a viable alternative to synthetic mesh, particularly for high-risk patients and in contaminated settings. However, a comparison of clinical outcomes between the currently available biologic mesh types has yet to be performed.
We performed a retrospective analysis of 141 patients who had undergone ventral hernia repair with biologic mesh, including noncross-linked porcine ADM (NC-PADM) (n = 51), cross-linked porcine ADM (C-PADM) (n = 17), reinforced biologic ovine rumen (RBOR) (n = 36), and bovine ADM (BADM) (n = 37) at the Stanford University Medical Center between 2002 and 2020. Postoperative donor site complications and rates of hernia recurrence were compared between patients with different biologic mesh types.
Abdominal complications occurred in 47.1% of patients with NC-PADM, 52.9% of patients with C-PADM, 16.7% of patients with RBOR, and 43.2% of patients with BADM ( = 0.015). Relative risk for overall complications was higher in patients who had received NC-PADM (RR = 2.64, = 0.0182), C-PADM (RR = 3.19, = 0.0127), and BADM (RR = 2.11, = 0.0773) compared with those who had received RBOR. Furthermore, relative risk for hernia recurrence was also higher in all other mesh types compared with RBOR.
Our data indicate that RBOR decreases abdominal complications and recurrence rates after ventral hernia repair compared with NC-PADM, C-PADM, and BADM.
在腹疝修补术中使用生物补片加强腹壁已被提议作为合成补片的可行替代方案，特别是对于高危患者和污染环境。然而，目前可用的生物补片类型之间的临床结果比较尚未进行。
我们对141例行生物补片腹疝修补术的患者进行了回顾性分析，这些患者于2002年至2020年在斯坦福大学医学中心接受手术，其中包括非交联猪脱细胞真皮基质（NC-PADM）（n = 51）、交联猪脱细胞真皮基质（C-PADM）（n = 17）、强化生物羊瘤胃（RBOR）（n = 36）和牛脱细胞真皮基质（BADM）（n = 37）。比较不同生物补片类型患者的术后供区并发症和疝复发率。
NC-PADM组47.1%的患者、C-PADM组52.9%的患者、RBOR组16.7%的患者和BADM组43.2%的患者发生腹部并发症（P = 0.015）。与接受RBOR的患者相比，接受NC-PADM（RR = 2.64，P = 0.0182）、C-PADM（RR = 3.19，P = 0.0127）和BADM（RR = 2.11，P = 0.0773）的患者总体并发症相对风险更高。此外，与RBOR相比，所有其他补片类型的疝复发相对风险也更高。
我们的数据表明，与NC-PADM、C-PADM和BADM相比，RBOR可降低腹疝修补术后的腹部并发症和复发率。
