Annals of surgery published:" acellular dermal matrix provides durable long-term outcomes in abdominal wall reconstruction: a study of patients with over 60 months of follow.
" background: ventral hernia repair(vhr) is one of the most commonly performed procedures in the united states, but studies assessing the long-term outcomes of vhr using biologic mesh are scarce.
Methods: "we conducted a retrospective cohort study of patients who underwent awr using either porcine adm(padm) or bovine adm(badm) from 2005 to 2019.
We analyzed the full cohort and a subset of our population with minimum long-term follow-up(ltf) of 5 years.
The primary outcome measure was hr.
Secondary outcomes were ssos.
" results: "we identified a total of 725 awrs (49.
5% padm, 50.
5% badm).
Mean age was 69±11.
5 years and mean body mass index was 31±7 kg/m2.
Forty-two percent of the defects were clean at the time of awr, 44% were clean-contaminated, and 14% were contaminated/infected.
Mean defect size was 180±174 cm2, mean mesh size was 414±203 cm2.
Hernia recurred in 93 patients(13%), with cumulative hr rates of 4.
9%, 13.
5%, 17.
3%, and 18.
8% at 1, 3, 5, and 7 years, respectively.
There were no differences in hr(p = 0.
83) and sso(p = 0.
87) between the two mesh types.
Ssos were identified in 27% of patients.
In our ltf group (n = 162), the hr rate was 16%.
Obesity, bridged repair, and concurrent stoma presence/creation were independent predictors of hr; component separation was protective against hr.
" conclusions: despite its use in complex awr, adm provides durable long-term outcomes with relatively low recurrence rates.
Doi: 10.
1097/sla.
0000000000004454.
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