Department of Surgery, Montefiore Medical Center, The Bronx , New York, United States.
Division of General Surgery, NYU Langone Health, New York, United States.
Arq Gastroenterol. 2022 Apr-Jun;59(2):226-230. doi: 10.1590/S0004-2803.202202000-41.
Poly-4-hydroxybutyrate (P4HB) is a naturally occurring polymer derived from transgenic E. coli bacteria with the longest degradation rate when compared to other available products. This polymer has been manufactured as a biosynthetic mesh to be used as reinforcement when repairing a variety of abdominal wall defects.
We aim to describe our center initial experience with this mesh and discuss the possible indications that may benefit from the use of P4HB mesh.
This is a descriptive retrospective study of patients who underwent abdominal wall repair with a P4HB mesh from October 2018 to December 2020 in a single, large volume, academic center.
A total of 51 patients (mean age 54.4 years, range 12-89) underwent abdominal wall reconstruction with a P4HB mesh between October 2018 and December 2020. The mean BMI was 30.5 (range 17.2-50.6). Twenty-three (45%) patients had a prior hernia repair at the site. We grouped patients into six different indications for the use of P4HB mesh in our cohort: clean-contaminated, contaminated or infected field (57%), patient refusal for permanent meshes (14%), those with high risk for post-operative infection (12%), visceral protection of second mesh (10%), recurrence with related chronic pain from mesh (6%), and children (2%). Median follow-up was 105 days (range 8-648). Two patients had hernia recurrence (4%) and 8 (16%) patients developed seroma.
P4HB mesh is a safe and a viable alternative for complex hernias and high-risk patients with a low complication rate in the short-term.
聚-4-羟基丁酸酯（P4HB）是一种源自转基因大肠杆菌的天然聚合物，与其他可用产品相比，其降解速度最快。这种聚合物已被制成生物合成网，用于修复各种腹壁缺陷时作为增强材料。
我们旨在描述我们中心使用这种网的初始经验，并讨论可能受益于使用 P4HB 网的各种适应证。
这是一项对 2018 年 10 月至 2020 年 12 月期间在一家大型学术中心接受 P4HB 网修复腹壁的患者进行的描述性回顾性研究。
共有 51 例患者（平均年龄 54.4 岁，范围 12-89 岁）在 2018 年 10 月至 2020 年 12 月期间接受了 P4HB 网的腹壁重建。平均 BMI 为 30.5（范围 17.2-50.6）。23 例（45%）患者在该部位有先前的疝修补术。我们将患者分为我们队列中使用 P4HB 网的六个不同适应证：清洁污染、污染或感染部位（57%）、患者拒绝使用永久性网（14%）、术后感染风险高的患者（12%）、第二张网的内脏保护（10%）、因网相关慢性疼痛而复发的患者（6%）和儿童（2%）。中位随访时间为 105 天（范围 8-648 天）。2 例患者（4%）出现疝复发，8 例（16%）患者出现血清肿。
P4HB 网是一种安全且可行的复杂疝和高风险患者的替代方法，短期并发症发生率低。
