<oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:creator>Jakob MO</dc:creator>
  <dc:creator>Spari D</dc:creator>
  <dc:creator>Zindel J</dc:creator>
  <dc:creator>Pinworasarn T</dc:creator>
  <dc:creator>Candinas D</dc:creator>
  <dc:creator>Beldi G</dc:creator>
  <dc:date>2018</dc:date>
  <dc:description xmlns:ns0="xml" ns0:lang="en">BACKGROUND
Primary closure of post-operative facial dehiscence (FD) is associated with a high incidence of recurrence, revisional surgery, and incisional hernia. This retrospective study compares outcomes of implantation of non-absorbable intra-abdominal meshes with primary closure of FD. The outcomes of different mesh materials were assessed in subgroup analysis.


METHODS
A total of 119 consecutive patients with FD were operated (70 mesh group and 49 no mesh group) between 2001 and 2015. Primary outcome parameter was hernia-free survival. Secondary outcome parameters include re-operations of the abdominal wall, intestinal fistula, surgical site infections (SSI), and mortality. Kaplan-Meier analysis for hernia-free survival, adjusted Poisson regression analysis for re-operations and adjusted regression analysis for chronic SSI was performed.


RESULTS
Hernia-free survival was significantly higher in the mesh group compared to the no mesh group (P = 0.005). Fewer re-operations were necessary in the mesh group compared to the no mesh group (adjusted incidence risk ratio 0.44, 95% confidence interval [CI] 0.20-0.93, P = 0.032). No difference in SSI, intestinal fistula, and mortality was observed between groups. Chronic SSI was observed in 7 (10%) patients in the mesh group (n = 3 [6.7%] with polypropylene mesh and 4 [28.6%] with polyester mesh). The risk for chronic SSI was significantly higher if a polyester mesh was used when compared to a polypropylene mesh (adjusted odds ratio 8.69, 95% CI 1.30-58.05, P = 0.026).


CONCLUSION
Implantation of a polypropylene but not polyester-based mesh in patients with FD decreases incisional hernia with a low rate of mesh-related morbidity.</dc:description>
  <dc:format>application/pdf</dc:format>
  <dc:identifier>https://sonar.ch/global/documents/169832</dc:identifier>
  <dc:language>eng</dc:language>
  <dc:relation>info:eu-repo/semantics/altIdentifier/doi/10.1007/s11605-018-3873-z</dc:relation>
  <dc:relation>info:eu-repo/semantics/altIdentifier/pmid/30039450</dc:relation>
  <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
  <dc:source>Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. - 2018</dc:source>
  <dc:subject xmlns:ns1="xml" ns1:lang="en">Fascial dehiscence</dc:subject>
  <dc:subject xmlns:ns2="xml" ns2:lang="en">Non-absorbable mesh</dc:subject>
  <dc:subject xmlns:ns3="xml" ns3:lang="en">Polyester mesh</dc:subject>
  <dc:subject xmlns:ns4="xml" ns4:lang="en">Polypropylene mesh</dc:subject>
  <dc:subject xmlns:ns5="xml" ns5:lang="en">Aged</dc:subject>
  <dc:subject xmlns:ns6="xml" ns6:lang="en">Female</dc:subject>
  <dc:subject xmlns:ns7="xml" ns7:lang="en">Hernia, Ventral</dc:subject>
  <dc:subject xmlns:ns8="xml" ns8:lang="en">Humans</dc:subject>
  <dc:subject xmlns:ns9="xml" ns9:lang="en">Incisional Hernia</dc:subject>
  <dc:subject xmlns:ns10="xml" ns10:lang="en">Intestinal Fistula</dc:subject>
  <dc:subject xmlns:ns11="xml" ns11:lang="en">Male</dc:subject>
  <dc:subject xmlns:ns12="xml" ns12:lang="en">Middle Aged</dc:subject>
  <dc:subject xmlns:ns13="xml" ns13:lang="en">Odds Ratio</dc:subject>
  <dc:subject xmlns:ns14="xml" ns14:lang="en">Peritoneum</dc:subject>
  <dc:subject xmlns:ns15="xml" ns15:lang="en">Polyesters</dc:subject>
  <dc:subject xmlns:ns16="xml" ns16:lang="en">Polypropylenes</dc:subject>
  <dc:subject xmlns:ns17="xml" ns17:lang="en">Prosthesis Implantation</dc:subject>
  <dc:subject xmlns:ns18="xml" ns18:lang="en">Recurrence</dc:subject>
  <dc:subject xmlns:ns19="xml" ns19:lang="en">Reoperation</dc:subject>
  <dc:subject xmlns:ns20="xml" ns20:lang="en">Retrospective Studies</dc:subject>
  <dc:subject xmlns:ns21="xml" ns21:lang="en">Risk</dc:subject>
  <dc:subject xmlns:ns22="xml" ns22:lang="en">Surgical Mesh</dc:subject>
  <dc:subject xmlns:ns23="xml" ns23:lang="en">Surgical Wound Dehiscence</dc:subject>
  <dc:subject xmlns:ns24="xml" ns24:lang="en">Surgical Wound Infection</dc:subject>
  <dc:subject xmlns:ns25="xml" ns25:lang="en">Survival Analysis</dc:subject>
  <dc:title xmlns:ns26="xml" ns26:lang="en">Prophylactic, Synthetic Intraperitoneal Mesh Versus No Mesh Implantation in Patients with Fascial Dehiscence.</dc:title>
  <dc:type>http://purl.org/coar/resource_type/c_6501</dc:type>
</oai_dc:dc>
