DeNoto George
General Surgery Department, St. Francis Hospital, Roslyn, NY, 11576, USA.
Ann Med Surg (Lond). 2022 Mar 2;75:103446. doi: 10.1016/j.amsu.2022.103446. eCollection 2022 Mar.
Of all hernia types, large ventral hernias have the most impact on patient quality of life, however they are also the most difficult type of hernia to repair and are associated with high rates of complications. This case series describes repair of large ventral hernias with an ovine reinforced biologic in a complex patient cohort with comorbidities and concomitant procedures.
The author performed bridged repair with an ovine reinforced biologic in 19 consecutive high-risk patients over a 5-year period. In all cases the reinforced biologic was used as an underlay.
Of the 19 patients, six (32%) experienced a surgical site occurrence including infection, seroma, abscess, fistula, bioloma, or bowel obstruction. Three patients (16%) had recurrences with two out of three of the recurrences occurring within 6 months of surgery.
Rates of SSO's and recurrences using ovine reinforced tissue matrix (RTM) were in line with or better than other published studies of bridged repair utilizing biologic or synthetic mesh reinforcement. Ovine RTM's should therefore be considered in complex large ventral hernia repairs.
在所有类型的疝气中，大型腹壁疝对患者生活质量的影响最大，然而，它们也是最难修复的疝气类型，并且并发症发生率很高。本病例系列描述了在患有合并症和伴随手术的复杂患者队列中，使用羊源强化生物材料修复大型腹壁疝的情况。
作者在5年期间对19例连续的高危患者进行了羊源强化生物材料的桥接修复。在所有病例中，强化生物材料均用作衬垫。
19例患者中，6例（32%）发生了手术部位事件，包括感染、血清肿、脓肿、瘘管、生物瘤或肠梗阻。3例患者（16%）出现复发，其中3例中有2例在术后6个月内复发。
使用羊源强化组织基质（RTM）的手术部位事件和复发率与其他发表的关于使用生物或合成网片强化进行桥接修复的研究相当或更好。因此，在复杂的大型腹壁疝修复中应考虑使用羊源RTM。
