Gnaneswaran, Neiraja, Perera, Marlon, Jenkin, Ashley, Lau, Henry, and Presley, Robert (2016) Ventral hernia repair with lateral component separation and onlay Biodesign graft. European Journal of Plastic Surgery, 39 (4). pp. 279-286.

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Abstract

Ventral hernia is common, complicating up to 20 % of laparotomies. Plication of the rectus sheath with lateral component separation (LCS) provides a durable repair with acceptable functional outcomes. Additional support to the anterior abdominal wall may be provided by synthetic or biological mesh. Biological grafts invoke local tissue remodeling and result in strong fibrocollagenous tissue able to support the dynamic stressor of the anterior abdominal wall. Biodesign graft is a new graft derived from porcine small-intestine submucosa. We aim to review the use of Biodesign mesh for repair of ventral hernia with LCS.

Patients underwent ventral hernia repair completed with plication of the rectus sheath, LCS, and use of an onlay Biodesign graft. Data was collected retrospectively. Key outcome measures included post-operative complications and recurrence.

Twelve patients were included for analysis. Mean age was 51.2 years, with 50 % males and a median weight of 87 kg (65-111 kg). Median operative time was 210 min (147 to 278 min) and median length of stay was 4 days. At a mean follow-up of 14.0 months, 8/12 (66 %) developed seroma, 1/12 (8 %) developed abdominal wall abscess, and 1/12 (8 %) suffered flap failure requiring vacuum dressings for closure. No patients were complicated by ventral hernia recurrence.

Our results describe an early Australian experience of onlay Biodesign graft in the context of rectus sheath plication with LCS. We report acceptable rates of post-operative complications and recurrence.

Level of evidence: IV, therapeutic study.

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