Fafaj Aldo, Beffa Lucas R A, Petro Clayton C, Prabhu Ajita S, Miller Benjamin T, Huang Li-Ching, Ellis Ryan C, Maskal Sara M, Messer Nir, Mazzola Poli de Figueiredo Sergio, Rosen Michael J
Center for Abdominal Core Health, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, United States.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States.
J Abdom Wall Surg. 2025 Apr 4;4:14316. doi: 10.3389/jaws.2025.14316. eCollection 2025.
The mesh choice for the majority of our retromuscular repairs is heavyweight knitted polypropylene (KP) mesh. However, supply chain issues necessitated a change to a newer non-woven polypropylene mesh (NWP). We aimed to evaluate our initial experience with using NWP mesh in retromuscular abdominal wall reconstruction.
We performed a retrospective review of all patients at our institution who underwent elective, open incisional hernia repair with NWP or KP mesh from January 2014 until December 2023. The analyzed variables included patient demographics, comorbidities, operative techniques, mesh type, position, and postoperative outcomes. A propensity score model and matching algorithms were implemented to address potential treatment-choice bias. Patients receiving NWP mesh were matched with patients receiving KP mesh in a 1:2 ratio.
A total of 771 patients were included in the study, 63 (8.2%) patients had their hernia repaired with NWP and 708 (91.2%) patients with KP mesh. After propensity score matching, 63 patients in the NWP group and 126 in the KP were analyzed. At 30-day follow-up, there were significantly more deep SSIs in the NWP group, however, there were no differences in readmission, reoperation, hernia recurrence, and overall SSI, SSO, and SSOPI.
Retromuscular hernia repaired with non-woven polypropylene mesh showed no difference in readmission, reoperation, hernia recurrence, and overall SSI, SSO, and SSOPI when compared with knitted polypropylene. There were significantly more deep SSIs in the NWP group; however, in all cases, the mesh was salvaged with local wound care, and all patients made a complete recovery. In the short term, the use of NWP mesh appears to be safe, with outcomes comparable to KP mesh.
我们大多数经肌后修补手术选用的补片是重磅针织聚丙烯(KP)补片。然而,供应链问题使得我们不得不改用一种更新的非织造聚丙烯补片(NWP)。我们旨在评估在经肌后腹壁重建中使用NWP补片的初步经验。
我们对2014年1月至2023年12月在本机构接受择期开放性切口疝修补术并使用NWP或KP补片的所有患者进行了回顾性研究。分析的变量包括患者人口统计学资料、合并症、手术技术、补片类型、位置及术后结果。采用倾向评分模型和匹配算法来解决潜在的治疗选择偏倚。接受NWP补片的患者与接受KP补片的患者按1:2的比例进行匹配。
本研究共纳入771例患者,其中63例(8.2%)患者使用NWP补片修补疝,708例(91.2%)患者使用KP补片。倾向评分匹配后,对NWP组的63例患者和KP组的126例患者进行了分析。在30天随访时,NWP组的深部手术部位感染显著更多,然而,在再入院、再次手术、疝复发以及总体手术部位感染、手术部位浅表感染和手术部位浅表感染发生率方面并无差异。
与针织聚丙烯补片相比,使用非织造聚丙烯补片修补经肌后疝在再入院、再次手术、疝复发以及总体手术部位感染、手术部位浅表感染和手术部位浅表感染发生率方面并无差异。NWP组的深部手术部位感染显著更多;然而,在所有病例中,通过局部伤口护理均保留了补片,且所有患者均完全康复。短期内,使用NWP补片似乎是安全的,其结果与KP补片相当。