Components separation technique utilizing an intraperitoneal biologic and an onlay lightweight polypropylene mesh: “a sandwich technique”
Morris LM et al. – Repair of large, complex abdominal wall hernias by components separation technique (CST) augmented with a biologic underlay mesh and a lightweight polypropylene onlay mesh results in lower recurrence rates compared to historical reports of CST alone.Methods
- Patients with a large hernia defect with or without multiple recurrences were selected to undergo a CST augmented with an acellular dermal collagen mesh underlay.
- Following midline abdominal closure, a lightweight, large–pore polypropylene onlay mesh was fixed to the abdominal fascia.
- The skin and subcutaneous layers were closed over two sump drains and two closed suction drains.
- Fifty–one patients underwent a mesh–reinforced CST from May 2006 to June 2010.
- The study population averaged 57.9 ± 1.5 years of age with 24 males and 27 females, BMI of 34.3 ± 0.9 kg/m2, ASA score of 2.62 ± 0.08, 29 % were smokers, 29 % were diabetic, and 69 % had at least one previous abdominal wall hernia repair.
- Operative time averaged 196.5 ± 7.2 min with a blood loss of 318 ± 24 mL, and average hernia defect size of 301 ± 31 cm2.
- Length of follow–up averaged 20.6 ± 2.1 months; surgical site occurrences were identified in 39 %, most commonly from skin necrosis.
- Hernia recurrence rate was 3.9 %.