Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P043: LONG-TERM CLINICAL OUTCOMES OF AN ANTIBIOTIC-COATED NON-CROSSLINKED PORCINE ACELLULAR DERMAL GRAFT FOR ABDOMINAL WALL RECONSTRUCTION FOR HIGH-RISK AND CONTAMINATED WOUNDS
Jesse K Sulzer; Jordan Robinson; Patrick Salibi; John B Martinie; Erin H Baker; Lee Ocuin; Dionisios Vrochides; David A Iannitti; Division of HPB Surgery, Atrium Health
Background: Hernia repair in high-risk and contaminated cases remains a challenge due to the risk of mesh infection and hernia recurrence. Biologic grafts offer an attractive option for reinforcing the repair but long-term data on outcomes in this patient population remain limited. This study examines the use of XenMatrix AB in complex abdominal hernias in patients with a prior open abdomen or contaminated wounds.
Methods: Patients on the Hepatopancreaticobiliary service undergoing abdomen hernia repair with XenMatrix AB between 12/2014 and 12/2017 were included. Demographics along with prospectively recorded operative characteristics and outcomes were collected. Hernia grade was determined by the Ventral Hernia Working Group classification. Primary outcome was hernia recurrence. Secondary outcomes included length of stay, readmission, morbidity, and mortality.
Results: Twenty-two patients underwent abdominal hernia repair using XenMatrix AB during the study period. Two patients died while inpatient following their repair from progression of their comorbid diseases and were excluded. Seventy-five percent of patients had a midline hernia and 60% of patients had an open abdomen at time of repair. Ventral Hernia Working Group class 3 or 4 wounds were present in 85% of patients.
Average length of stay was 13 days with 30-day infectious complications including 3 with superficial cellulitis/fat necrosis (15%) and one intraperitoneal abscess (5%). No patients required re-operation or graft excision.
Median clinical follow-up was 29.7 months. Two asymptomatic recurrences were noted on imaging during this period, neither of which required reoperation. Follow-up was extended by phone interview utilizing the Ventral Hernia Recurrence Inventory which identified no additional recurrences at a median of 55.7 months.
Conclusion: This study presents long-term follow-up for patients with high-risk and contaminated wounds who underwent abdominal hernia repair reinforced with XenMatrix AB. Acceptable outcomes and complications were noted at both follow-up periods and provide support for the use of biologic grafts in this complicated patient population.
Click the image below to expand: