Abstract：
To assess mesh behaviour and clinical outcomes of open complex abdominal wall reconstruction (CAWR) with the use of a polypropylene reinforced tissue matrix.
A multicenter retrospective study of adult patients who underwent open CAWR with the use of a permanent polypropylene reinforced tissue matrix (OviTex®) between June 2019 and January 2021.
Fifty-five consecutive patients from four hospitals in the Netherlands were analysed; 46 patients with a ventral hernia and 9 patients with an open abdomen. Most patients with a ventral hernia had one or more complicating comorbidities (91.3%) and one or more complicating hernia characteristics (95.7%). Most procedures were performed in a (clean) contaminated surgical field (69.6% CDC 2-4; 41.3% CDC 3-4). All nine patients with an open abdomen underwent semi-emergent surgery. Twelve out of 46 patients with a ventral hernia (26.1%) and 4 of 9 patients with an open abdomen (44.4%) developed a postoperative surgical site infection that made direct contact with the mesh as confirmed on computed tomography (CT), suspicious of mesh infection. No patient needed mesh explantation for persistent infection of the mesh. During a median follow-up of 13 months, 4 of 46 ventral hernia patients (8.7%) developed a CT confirmed hernia recurrence.
Polypropylene reinforced tissue matrix can withstand infectious complications and provides acceptable mid-term recurrence rates in this retrospective study on open complex abdominal wall reconstructions. Longer follow-up data from prospective studies are required to determine further risk of hernia recurrence.
A multicenter retrospective study of adult patients who underwent open CAWR with the use of a permanent polypropylene reinforced tissue matrix (OviTex®) between June 2019 and January 2021.
Fifty-five consecutive patients from four hospitals in the Netherlands were analysed; 46 patients with a ventral hernia and 9 patients with an open abdomen. Most patients with a ventral hernia had one or more complicating comorbidities (91.3%) and one or more complicating hernia characteristics (95.7%). Most procedures were performed in a (clean) contaminated surgical field (69.6% CDC 2-4; 41.3% CDC 3-4). All nine patients with an open abdomen underwent semi-emergent surgery. Twelve out of 46 patients with a ventral hernia (26.1%) and 4 of 9 patients with an open abdomen (44.4%) developed a postoperative surgical site infection that made direct contact with the mesh as confirmed on computed tomography (CT), suspicious of mesh infection. No patient needed mesh explantation for persistent infection of the mesh. During a median follow-up of 13 months, 4 of 46 ventral hernia patients (8.7%) developed a CT confirmed hernia recurrence.
Polypropylene reinforced tissue matrix can withstand infectious complications and provides acceptable mid-term recurrence rates in this retrospective study on open complex abdominal wall reconstructions. Longer follow-up data from prospective studies are required to determine further risk of hernia recurrence.
摘要：
评估使用聚丙烯增强组织基质的开放式复杂腹壁重建（CAWR）的网状行为和临床结果。
在2019年6月至2021年1月期间使用永久性聚丙烯增强组织基质（OviTex®）进行开放式CAWR的成年患者的多中心回顾性研究。
分析了荷兰四家医院的55例连续患者；46例腹疝患者和9例腹部开放患者。大多数腹侧疝患者有一种或多种复杂的合并症（91.3％）和一种或多种复杂的疝特征（95.7％）。大多数程序在（清洁）污染的手术区域中进行（69.6％CDC2-4；41.3％CDC3-4）。所有9例腹部开放的患者均接受了半紧急手术。46例腹疝患者中有12例（26.1％）和9例腹部开放患者中有4例（44.4％）发生了术后手术部位感染，如计算机断层扫描（CT）所证实的那样，与网片直接接触。可疑网状物感染。没有患者需要网片外植术来持续感染网片。在13个月的中位随访中，46例腹疝患者中有4例（8.7％）出现CT证实的疝复发。
在这项开放性复杂腹壁重建的回顾性研究中，聚丙烯增强的组织基质可以承受感染性并发症，并提供可接受的中期复发率。需要从前瞻性研究中获得更长时间的随访数据来确定进一步的疝气复发风险。
在2019年6月至2021年1月期间使用永久性聚丙烯增强组织基质（OviTex®）进行开放式CAWR的成年患者的多中心回顾性研究。
分析了荷兰四家医院的55例连续患者；46例腹疝患者和9例腹部开放患者。大多数腹侧疝患者有一种或多种复杂的合并症（91.3％）和一种或多种复杂的疝特征（95.7％）。大多数程序在（清洁）污染的手术区域中进行（69.6％CDC2-4；41.3％CDC3-4）。所有9例腹部开放的患者均接受了半紧急手术。46例腹疝患者中有12例（26.1％）和9例腹部开放患者中有4例（44.4％）发生了术后手术部位感染，如计算机断层扫描（CT）所证实的那样，与网片直接接触。可疑网状物感染。没有患者需要网片外植术来持续感染网片。在13个月的中位随访中，46例腹疝患者中有4例（8.7％）出现CT证实的疝复发。
在这项开放性复杂腹壁重建的回顾性研究中，聚丙烯增强的组织基质可以承受感染性并发症，并提供可接受的中期复发率。需要从前瞻性研究中获得更长时间的随访数据来确定进一步的疝气复发风险。
