Use of polyvinylidene fluoride (PVDF) meshes for ventral hernia repair in emergency surgery
- 22 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Hernia
- Vol. 25 (1), 99-106
- https://doi.org/10.1007/s10029-020-02209-3
Abstract
Purpose The implantation of non-absorbable meshes is the gold standard technique for ventral hernia (VH) repairs. However, emergency surgeries are often related to contaminated/infected fields, where the implantation of prosthetic materials may not be recommendable. Our aim was to evaluate the results of polyvinylidene fluoride (PVDF) meshes used for contaminated and/or complicated VH repairs in the acute setting. Methods We conducted a retrospective analysis of patients with VH who underwent emergency surgery involving PVDF meshes, in a tertiary hospital (from November 2013 to September 2019). We analyzed postoperative complications and 1-year recurrence rates. We evaluated the relationships between contamination grade, mesh placement, infectious complications, and recurrences. Results We gathered data on 123 patients; their mean age was 62.3 years, their mean BMI was 31.1 kg/m2, and their mean CeDAR index was 51.6. 96.4% of patients had a grade 2–3 ventral hernia according to the Rosen index. The mean defect width was 8 cm (IQR 2–18). 93 cases (75.6%) were described as contaminated or dirty surgeries. A PVDF mesh was placed using an IPOM technique in 56.3% of cases, and via interposition location in 39.9%. The one-month recurrence rate was 5.7% and recurrence after one year was 19.1%. The overall mortality rate was 27.6%. Risk of recurrence was related to patients with a Rosen score over 2 (p < 0.001), as well as with postoperative SSI (p = 0.045). Higher recurrence rates were not related to PVDF mesh placement. Conclusion The use of PVDF meshes for emergency VH repairs in contaminated surgeries seems safe and useful, with reasonable recurrence rates, and acceptable infectious complication rates, similar to those published in the literature.Keywords
This publication has 33 references indexed in Scilit:
- A 5-Year Clinical Experience With Single-Staged Repairs of Infected and Contaminated Abdominal Wall Defects Utilizing Biologic MeshAnnals of Surgery, 2013
- Prospective study of single-stage repair of contaminated hernias using a biologic porcine tissue matrix: The RICH StudySurgery, 2012
- Risk Factors for Incisional Hernia and Parastomal Hernia after Colorectal SurgeryJournal of the Korean Society of Coloproctology, 2012
- Use of Mesh During Ventral Hernia Repair in Clean-Contaminated and Contaminated CasesAnnals of Surgery, 2012
- Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair!Hernia, 2008
- Adhesion formation of a polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal modelSurgical Endoscopy, 2008
- Long-term Follow-up of a Randomized Controlled Trial of Suture Versus Mesh Repair of Incisional HerniaAnnals of Surgery, 2004
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Guideline for Prevention of Surgical Site Infection, 1999American Journal of Infection Control, 1999