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One-year outcome after repair of giant incisional hernia using synthetic mesh or full-thickness skin graft: a randomised controlled trial
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. (Clister)
Department of Molecular Medicine and Surgery, Karolinska Institute, Solna, Sweden.. (Clister)
Department of Clinical Science and Education, Karolinska Institute, Solna, Sweden..
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. (Clister)
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2019 (English)In: Hernia, ISSN 1265-4906, E-ISSN 1248-9204, Vol. 23, no 2, p. 355-361Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Repair of giant incisional hernia often requires complex surgery and the results of conventional methods using synthetic mesh as reinforcement are unsatisfactory, with high recurrence and complication rates. Our hypothesis was that full-thickness skin graft (FTSG) provides an alternative reinforcement material for giant incisional hernia repair and that outcome is improved. The aim of this study was to compare FTSG with conventional materials currently used as reinforcement in the repair of giant incisional hernia.

METHODS: A prospective randomised controlled trial was conducted, comparing FTSG with synthetic mesh as reinforcement in the repair of giant (> 10 cm minimum width) incisional hernia. One-year follow-up included a blinded clinical examination by a surgeon and objective measurements of abdominal muscle strength using the Biodex-4 system.

RESULTS: 52 patients were enrolled in the study: 24 received FTSG and 28 synthetic mesh. Four recurrences (7.7%) were found at 1-year follow-up, two in each group. There were no significant differences regarding pain, patient satisfaction or aesthetic outcome between the groups. Strength in the abdominal wall was not generally improved in the study population and there was no significant difference between the groups.

CONCLUSION: The outcome of repair of giant incisional hernia using FTSG as reinforcement is comparable with repair using synthetic mesh. This suggests that FTSG may have a future place in giant incisional hernia repair.

Place, publisher, year, edition, pages
Springer, 2019. Vol. 23, no 2, p. 355-361
Keywords [en]
Abdominal muscle strength, Full-thickness skin, Incisional hernia, Recurrence rate, Ventral hernia
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-156474DOI: 10.1007/s10029-019-01900-4ISI: 000464888100022PubMedID: 30737622Scopus ID: 2-s2.0-85061249726OAI: oai:DiVA.org:umu-156474DiVA, id: diva2:1289346
Available from: 2019-02-18 Created: 2019-02-18 Last updated: 2019-06-13Bibliographically approved

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Strigård, Karin

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