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dc.contributor.authorGarcía Ureña, Miguel Ángel
dc.contributor.authorLópez Monclús, Javier
dc.contributor.authorCuccurullo, Diego
dc.contributor.authorBlázquez Hernando, Luis Alberto
dc.contributor.authorGarcía Pastor, Providencia
dc.contributor.authorReggio, Stefano
dc.contributor.authorJiménez Cubedo, Elena
dc.contributor.authorSan Miguel Méndez, Carlos
dc.contributor.authorCruz Cidoncha, Arturo
dc.contributor.authorRobin Valle de Lersundi, Álvaro
dc.date.accessioned2019-04-08T10:15:57Z
dc.date.available2019-04-08T10:15:57Z
dc.date.issued2018
dc.identifier.issn0364-2313spa
dc.identifier.urihttp://hdl.handle.net/10641/1598
dc.description.abstractBackground Optimal mesh reinforcement for abdominal wall reconstruction (AWR) in complex hernias remains questionable. Use of biologic, absorbable and synthetic meshes has been described. The idea of using an absorbable mesh (AM) under a permanent mesh (PM) in a retromuscular position may help in these challenging situations. Methods Between 2011 and 2016, consecutive patients undergoing open AWR utilizing an AM as posterior layer reinforcement and configuration of a large PM were identified in a multicenter prospectively maintained database in four hospitals. Main outcomes included demographics, ventral hernia classifications, perioperative data, complications and recurrences. Results A total of 169 complex incisional hernias were analyzed. Mean age was 60.9, with mean body mass index 30.7 (range: 20–46). Location of incisional hernias (IH) was: 80 midline, 59 lateral and 30 midline and lateral. 78% were grade I and II in Ventral Hernia Working Group classification. 52% of patients were discharged with no complication. There were 19% seromas, 13% hematomas, 12% surgical-site infection and 10% skin dehiscence. Only partial mesh removal was necessary in one patient. After a mean follow-up of 26 months (range 15–59), there were five (3.2%) recurrences. Reoperations on patients showed a band of fibrosis separating the peritoneum from the PM. Conclusion The combination of AM with very large PM in the same retromuscular position in AWR seems to be safe. The efficacy with recurrence rates below 4% in complex midline and lateral IH may be explained by the use of larger PMs that are extended and configured with the support of AMs. Reoperations on patients have confirmed the previous experimental reports on the use of the AM.spa
dc.language.isoengspa
dc.publisherWorld Journal of Surgeryspa
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 España*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/es/*
dc.titleAbdominal Wall Reconstruction Utilizing the Combination of Absorbable and Permanent Mesh in a Retromuscular Position: A Multicenter Prospective Study.spa
dc.typearticlespa
dc.description.versionpre-printspa
dc.rights.accessRightsopenAccessspa
dc.description.extent1351 KBspa
dc.identifier.doi10.1007/s00268-018-4765-9spa


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