A comparative analysis of ventral hernia repair with a porcine hepatic-derived matrix and porcine dermal matrix

• Published in: International Journal of Abdominal Wall and Hernia Surgery Vol. 2; no. 3; pp. 89 - 95
• Main Authors: Tharappel, Job, Wennergren, John, Lee, Eun, Madabhushi, Vashisht, Plymale, Margaret, Roth, John
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01.07.2019; Wolters Kluwer Medknow Publications
• Subjects: Analysis; animal model; Aprotinin; dermal mesh; Hernia; hernia repair; outcomes; Swine
• ISSN: 2589-8736; 2589-8078; 2589-8078
• DOI: 10.4103/ijawhs.ijawhs_20_19

PURPOSE: Complex abdominal wall hernia repairs present unique challenges for patients and surgeons, often requiring mesh placement. Biologic materials may be utilized in repairs with high risk for postoperative complications. Porcine dermal meshes (PDM) are among the most commonly utilized biologic grafts. Porcine hepatic biologic mesh (PHM) was developed due to its unique characteristics. This study investigates outcomes following acute ventral hernia repair with a porcine-derived hepatic biologic mesh (Miromesh®) and porcine dermis (Strattice™) in a porcine animal model. MATERIALS AND METHODS: Twenty Yucatan pigs underwent hernia creation followed by immediate retrorectus ventral hernia repair and were survived for 1 (n = 4), 2 (n = 6), 6 (n = 5), or 12 (n = 5) months. Animals underwent excision of the anterior abdominal wall and immediate repair with both PDM and PHM positioned in the retrorectus space with 3 cm between grafts. Animals were survived and evaluated for tensiometric strength, histology, and protein analyses. RESULTS: Twenty animals underwent successful hernia creation and repair. Tensiometric strength was similar between repair groups at 1 (63.8 vs. 67.0 N, NS) and 2 months (80.0 vs. 76.1 N, NS), whereas at 6 (72.2 vs. 44.9 N, P= 0.01) and 12 months (66.7 vs. 46.3, P= 0.004), repair strength was greater in PHM. Histological evaluation demonstrated greater inflammation and fibrosis at 12 months in the PHM repairs. Collagen 1 deposition was greater in PHM at 1 (P = 0.1) and 2 (P = 0.015) months. There was no difference in collagen 3 deposition between groups. CONCLUSIONS: Ventral hernia repair with a porcine hepatic mesh results in greater repair strength than repair with porcine dermal grafts.