Single institutional experience using biological mesh for abdominal wall reconstruction.

Background: Complex ventral hernias remain a challenge. We present a study evaluating outcomes of complex ventral hernia repair using human-derived acellular dermal matrix (AlloDerm) and porcine-derived acellular dermal sheet (Permacol).

Methods: A retrospective review of 251 patients undergoing complex hernia repair was performed. Primary outcome was hernia recurrence; and secondary outcomes included early and late complications and mortality.

Results: Recurrence for Permacol versus AlloDerm was 32% versus 47% (P = .02). There was a difference in early complications (48% vs 30%, P = .007) and also late complications (30% vs 21%, P = .16) of Permacol versus AlloDerm. Overall survival was 85% for the Permacol group versus 78% for the AlloDerm group (P = .23). Recurrence for Permacol versus AlloDerm for underlay technique was 19% versus 22% and that for bridging technique was 44% versus 57%.

Conclusion: There exists a high complication rate from both Permacol and AlloDerm in complex ventral hernia repair especially when used as a fascial bridge.