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Cited by 14

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Long‐Term Outcomes in Complex Abdominal Wall Reconstruction Repaired With Absorbable Biologic Polymer Scaffold (Poly‐4‐Hydroxybutyrate)

Buell, Joseph F., Flaris, Alexandros N., Raju, Sukreet, Hauch, Adam, Darden, Michael, Parker, Geoff G.·2021·Annals of Surgery Open
DOI 10.1097/as9.0000000000000032
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Abstract

Introduction: After promising early outcomes in the use of absorbable biologic mesh for complex abdominal wall reconstruction, significant criticism has been raised over the longevity of these repairs after its 2-year resorption profile. Methods: This is the long-term (5-year) follow-up analysis of our initial experience with the absorbable polymer scaffold poly-4-hydroxybutyrate (P4HB) mesh compared with a consecutive contiguous group treated with porcine cadaveric mesh for complex abdominal wall reconstructions. Our clinical analysis was performed using Stata 14.2 and Excel 16.16.23. Results: After a 5-year follow-up period, the P4HB group (n = 31) experienced lower rates of reherniation (12.9% vs 38.1%; P = 0.017) compared with the porcine cadaveric mesh group (n = 42). The median interval in months to recurrent herniation was similar between groups (24.3 vs 20.8; P = 0.700). Multivariate logistic regression analysis on long-term outcomes identified smoking ( P = 0.004), African American race ( P = 0.004), and the use of cadaveric grafts ( P = 0.003) as risks for complication while smoking ( P = 0.034) and the use of cadaveric grafts ( P = 0.014) were identified as risks for recurrence. The long-term cost analysis showed that P4HB had a $10,595 per case costs savings over porcine cadaveric mesh. Conclusions: Our study identified the superior outcomes in clinical performance and a value-based benefit of absorbable biologic P4HB scaffold persisted after the 2-year resorption timeframe. Data analysis also confirmed the use of porcine cadaveric grafts independently contributed to the incidence of complications and recurrences.

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Research works printed but not linked: 29

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Cited by

Metadata

Authors
Buell, J. F., Flaris, A. N., Raju, S., Hauch, A., Darden, M., & Parker, G. G.
Affiliations
  • Department of Surgery, Mission Health, HCA North Carolina, MAHEC, University of North Carolina, Asheville, NC
  • Department of Surgery, Tulane University, New Orleans, LA
  • Department of Surgery, University of California, San Diego, CA
  • Carey Business School, Johns Hopkins University, Baltimore, MD
  • Thayer School of Engineering, Dartmouth College, Hanover, NH.
Venue
Annals of Surgery Open
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-03
Volume
2
Issue
1
Pages
e032
ISSN
2691-3593
DOI
10.1097/as9.0000000000000032
Cited by
14
References
0
Language
en
Licence
creativecommons.org/licenses/by-nc-nd/4.0/ (unspecified)

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