Use of polyvinylidene fluoride (PVDF) meshes for ventral hernia repair

in emergency surgery

A. Sánchez‑Arteaga1 · L. Tallón‑Aguilar1 · J. Tinoco‑González1 · E. Perea del‑Pozo1 · A. Navas‑Cuellar1 · J. Padillo‑Ruíz1

Received: 18 January 2020 / Accepted: 4 May 2020

© Springer-Verlag France SAS, part of Springer Nature 2020

Abstract

Purpose The implantation of nonabsorbable meshes is the gold standard technique for ventral hernia (VH) repairs. However,emergency surgeries are often related to contaminated/infected fields, where the implantation of prosthetic materials may not be recommendable. Our aim was to evaluate the results of polyvinylidene fluoride (PVDF) meshes used for contaminated and/or complicated VH repairs in the acute setting.

Methods We conducted a retrospective analysis of patients with VH who underwent emergency surgery involving PVDF meshes, in a tertiary hospital (from November 2013 to   September 2019).   We analyzed postoperative complications and 1-year recurrence   rates.   We evaluated the relationships between contamination grade, mesh placement, infectious complications, and recurrences.

Results We gathered data on 123 patients; their mean age was 62.3 years, their mean BMI was 31.1 kg/m2, and their mean CeDAR index was 51.6. 96.4%   of patients had a   grade   2–3 ventral hernia according to the Rosen index. The mean defect width was   8 cm   (IQR 218). 93 cases (75.6%) were described as contaminated or dirty surgeries.   A PVDF mesh was placedusing an IPOM technique in 56.3% of cases, and via interposition location   in 39.9%. The one-month recurrence rate was 5.7% and recurrence after   one year was   19.1%.   The overall mortality rate was 27.6%. Risk of recurrence was related to patients with   a Rosen score over 2 (p < 0.001), as well as with postoperative SSI (p = 0.045). Higher recurrence rates were not related to PVDF mesh placement.

Conclusion The use of PVDF meshes for emergency VH repairs in contaminated surgeries seems safe and useful, with reasonable recurrence rates,   and acceptable infectious   complication rates, similar to those published in the literature.

Keywords Ventral hernia · Emergency surgery · Polyvinylidene fluoride · Non absorbable   meshes

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