Abstract：
To analyze the incisional hernia recurrence rate at a long-term follow-up using a biosynthetic long-term absorbable mesh in patients with a higher risk of surgical infection in a contaminated surgical field.
This was a retrospective multicentric study. All patients undergoing incisional hernia repair between 2016 and 2018 at 6 participating university centers were included. Patients were classified according to the Ventral Hernia Working Group (VHWG). All consecutive patients who underwent abdominal wall repair using biosynthetic long-term absorbable mesh (Phasix®) in contaminated fields (grade 3 and 4 of the VHWG classification) were included. Patients were followed-up until September 2021. Preoperative, operative, and postoperative data were collected. All patients\' surgical site infections (SSIs) and surgical site occurrences (SSOs) were recorded. The primary outcome of interest was the clinical incisional hernia recurrence rate.
One hundred and eight patients were included: 77 with VHWG grade 3 (71.3%) and 31 with VHWG grade 4 (28.7%). Median time follow-up was 41 months [24; 63]. Twenty-four patients had clinical recurrence during the follow-up (22.2%). The SSI and SSO rates were 24.1% and 36.1%, respectively. On multivariate analysis, risk factors for incisional hernia recurrence were previous recurrence, mesh location, and postoperative enterocutaneous fistula.
At the 3 year follow-up, the recurrence rate with a biosynthetic absorbable mesh (Phasix®) for incisional hernia repair in high-risk patients (VHWG grade 3 and 4) seemed to be suitable (22.2%). Most complications occurred in the first year, and SSI and SSO rates were low despite high-risk VHWG grading.
This was a retrospective multicentric study. All patients undergoing incisional hernia repair between 2016 and 2018 at 6 participating university centers were included. Patients were classified according to the Ventral Hernia Working Group (VHWG). All consecutive patients who underwent abdominal wall repair using biosynthetic long-term absorbable mesh (Phasix®) in contaminated fields (grade 3 and 4 of the VHWG classification) were included. Patients were followed-up until September 2021. Preoperative, operative, and postoperative data were collected. All patients\' surgical site infections (SSIs) and surgical site occurrences (SSOs) were recorded. The primary outcome of interest was the clinical incisional hernia recurrence rate.
One hundred and eight patients were included: 77 with VHWG grade 3 (71.3%) and 31 with VHWG grade 4 (28.7%). Median time follow-up was 41 months [24; 63]. Twenty-four patients had clinical recurrence during the follow-up (22.2%). The SSI and SSO rates were 24.1% and 36.1%, respectively. On multivariate analysis, risk factors for incisional hernia recurrence were previous recurrence, mesh location, and postoperative enterocutaneous fistula.
At the 3 year follow-up, the recurrence rate with a biosynthetic absorbable mesh (Phasix®) for incisional hernia repair in high-risk patients (VHWG grade 3 and 4) seemed to be suitable (22.2%). Most complications occurred in the first year, and SSI and SSO rates were low despite high-risk VHWG grading.
摘要：
目的：分析使用生物合成长期可吸收网片在污染的外科领域中手术感染风险较高的患者的长期随访中的切口疝复发率。
方法：这是一项回顾性多中心研究。纳入2016年至2018年在6个参与的大学中心接受切口疝修补术的所有患者。根据腹侧疝工作组（VHWG）对患者进行分类。包括在污染领域（VHWG分类的3级和4级）使用生物合成长期可吸收网状物（Phahix®）进行腹壁修复的所有连续患者。患者随访至2021年9月。术前,Operative,收集术后数据。记录所有患者的手术部位感染（SSIs）和手术部位发生情况（SSO）。感兴趣的主要结果是临床切口疝复发率。
结果：纳入108例患者：77例VHWG3级（71.3%），31例VHWG4级（28.7%）。中位随访时间为41个月[24；63]。24例患者在随访期间出现临床复发（22.2%）。SSI和SSO发生率分别为24.1%和36.1%，分别。在多变量分析中，切口疝复发的危险因素是既往复发,网格位置,和术后肠外瘘。
结论：在3年的随访中，在高危患者(VHWG3级和4级)中,采用生物合成可吸收网片(Phahix®)进行切口疝修补术的复发率似乎是合适的(22.2%).大多数并发症发生在第一年，尽管有高风险的VHWG分级，但SSI和SSO发生率较低。
方法：这是一项回顾性多中心研究。纳入2016年至2018年在6个参与的大学中心接受切口疝修补术的所有患者。根据腹侧疝工作组（VHWG）对患者进行分类。包括在污染领域（VHWG分类的3级和4级）使用生物合成长期可吸收网状物（Phahix®）进行腹壁修复的所有连续患者。患者随访至2021年9月。术前,Operative,收集术后数据。记录所有患者的手术部位感染（SSIs）和手术部位发生情况（SSO）。感兴趣的主要结果是临床切口疝复发率。
结果：纳入108例患者：77例VHWG3级（71.3%），31例VHWG4级（28.7%）。中位随访时间为41个月[24；63]。24例患者在随访期间出现临床复发（22.2%）。SSI和SSO发生率分别为24.1%和36.1%，分别。在多变量分析中，切口疝复发的危险因素是既往复发,网格位置,和术后肠外瘘。
结论：在3年的随访中，在高危患者(VHWG3级和4级)中,采用生物合成可吸收网片(Phahix®)进行切口疝修补术的复发率似乎是合适的(22.2%).大多数并发症发生在第一年，尽管有高风险的VHWG分级，但SSI和SSO发生率较低。
