Complex abdominal wall defect repair using biologic porcine matrix.

BACKGROUND: The management of patients with complex abdominal wall defect (CAWD) is challenging, and requires appropriate surgical planning, and intensive patient preparation in order to minimize postoperative complications. The aim of this work was to review the management of CAWD using one-stage repair with biologic mesh. METHODS: We retrospectively reviewed patients with CAWD having undergone repair with biologic mesh between January 2013 and October 2014. Demographics, preoperative assessment, intraoperative management and postoperative outcomes were assessed. RESULTS: A total of 15 patients were included. Biologic mesh was used for hernia repair with primary fascial closure (N.=12) or for bridging of the abdominal wall defect (N.=3). Seven patients presented postoperative complications Clavien-Dindo grade >3, and among them six required reoperation but no one required the mesh explantation. After a follow-up period of 12 months, four patients presented hernia recurrence and two required a later surgery. CONCLUSIONS: The use of biologic mesh allows single-stage repair of complex abdominal wall defects. The procedure involves significant postoperative morbidity, and requires intensive preoperative multidisciplinary preparation.