Single-stage repair of contaminated hernias using a novel antibiotic-impregnated biologic porcine submucosa tissue matrix

Single-stage repair of incisional hernias in contaminated fields has a high rate of surgical site infection (30-42%) when biologic grafts are used for repair. In an attempt to decrease this risk, a novel graft incorporating gentamicin into a biologic extracellular matrix derived from porcine small i...

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Published inBMC surgery Vol. 20; no. 1; p. 58
Main Authors Minor, Samuel, Brown, Carl J, Rooney, Paul S, Hodde, Jason P, Julien, Lisa, Scott, Tracy M, Karimuddin, Ahmer A, Raval, Manoj J, Phang, P Terry
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 30.03.2020
BioMed Central
BMC
Subjects
Abdominal wall reconstruction
Aminoglycosides
Antibiotics
Consent
Contamination
Disease control
Extracellular matrix
Gentamicin
Graft
Grafting
Health aspects
Hernia
Hernia repair
Hernias
Implantation
Infection
Infections
Intestine
Patients
Surgeons
Surgical implants
Surgical site infections
Toxicity
Xenografts
Hernia repair
Graft
Abdominal wall reconstruction
Contamination
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Summary:Single-stage repair of incisional hernias in contaminated fields has a high rate of surgical site infection (30-42%) when biologic grafts are used for repair. In an attempt to decrease this risk, a novel graft incorporating gentamicin into a biologic extracellular matrix derived from porcine small intestine submucosa was developed. This prospective, multicenter, single-arm observational study was designed to determine the incidence of surgical site infection following implantation of the device into surgical fields characterized as CDC Class II, III, or IV. Twenty-four patients were enrolled, with 42% contaminated and 25% dirty surgical fields. After 12 months, 5 patients experienced 6 surgical site infections (21%) with infection involving the graft in 2 patients (8%). No grafts were explanted. The incorporation of gentamicin into a porcine-derived biologic graft can be achieved with no noted gentamicin toxicity and a low rate of device infection for patients undergoing single-stage repair of ventral hernia in contaminated settings. The study was registered March 27, 2015 at www.clinicaltrials.gov as NCT02401334.
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ISSN:1471-2482
1471-2482
DOI:10.1186/s12893-020-00715-w