J reconstr Microsurg 2019; 35(05): 335-340
DOI: 10.1055/s-0038-1676470
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparison of Polypropylene and Bioabsorbable Mesh for Abdominal Wall Reinforcement following Microsurgical Breast Reconstruction

Sumanas Wanant Jordan
1  Department of Plastic Surgery and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Steven Andrew Schulz
1  Department of Plastic Surgery and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Amanda Marie Carraher
1  Department of Plastic Surgery and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
David Shannon Cabiling
1  Department of Plastic Surgery and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
› Institutsangaben
Weitere Informationen

Publikationsverlauf

19. Juni 2018

18. Oktober 2018

Publikationsdatum:
17. Dezember 2018 (eFirst)

Abstract

Background Abdominal wall morbidity following microvascular breast reconstruction continues to be an area of interest due to both functional and aesthetic concerns. Donor-site closure technique has been shown to affect bulge and hernia rates and ranges from primary closure to various uses of mesh. Few studies to date have compared types of mesh. The present study compares BARD polypropylene to bioabsorbable GORE Bio-A (polyglycolic acid/trimethylene carbonate) mesh used as a fascial underlay with primary fascial closure.

Methods A retrospective review of all consecutive deep inferior epigastric artery-based microvascular breast reconstructions, including perforator and muscle-sparing flaps, performed between September 2014 and February 2017 was performed. All patients underwent primary fascial closure with mesh underlay. Risk factors for the formation of an abdominal bulge or hernia were identified by multivariate logistic regression.

Results Eighty-seven patients, with 123 abdominal donor sites, were included. Heavy-weight polypropylene mesh was used for 58 donor sites, while polyglycolic acid/trimethylene carbonate mesh was used in 65 donor sites. The overall incidence of bulge or hernia was 11.4%. The bioabsorbable cohort experienced significantly more bulges/hernias than the polypropylene mesh cohort (20% vs. 1.7% by donor site). Time to diagnosis of bulge was longer for the bioabsorbable group (219 ± 107 vs. 69 days). Flap type and perforator row were not associated with bulge/hernia. The polyglycolic acid/trimethylene carbonate mesh was associated with a 13.3-fold risk of bulge/hernia (p = 0.016).

Conclusion Polyglycolic acid/trimethylene carbonate mesh is not appropriate for anterior rectus fascia reinforcement following abdominal tissue transfer.

Disclosures

The authors have no financial or nonfinancial disclosures related to this manuscript.