D. B. LePere1, M. P. Lundgren2, E. L. Rosato2, K. A. Chojnacki2, D. A. Ehrlich1, S. E. Copit1, P. J. Greaney1 1Thomas Jefferson University,Plastic Surgery,Philadelphia, PA, USA 2Thomas Jefferson University,General Surgery,Philadelphia, PA, USA
Introduction: Phasix is a biologic, fully absorbable polymer recently fashioned into a monofilament mesh scaffold being utilized for ventral hernia repair. The mesh has been shown, in a porcine model, to maintain support of a hernia repair site over a 52 week period. Little literature is available regarding outcomes using Phasix mesh for hernia repair. Early data available includes multi-center data outlining outcomes in a population consisting of a majority of primary hernia repairs. A study was undertaken to evaluate the performance of Phasix in a patient population consisting primarily of complex and recurrent hernias.
Methods: A single-institutional study was undertaken at Thomas Jefferson University Hospital in Philadelphia, PA to review outcomes of 52 patients between September 2014 and July 2015 in a population consisting primarily of complicated and recurrent hernias. Patient data extracted included demographic information, BMI, past medical history, past surgical history, mesh dimensions, operative and hospital course data, complications, and follow-up, including readmission.
Results: Fifty-two patients were identified upon review of our records (27 males, 25 females), all of which received overlay Phasix mesh for hernia repair after primary fascial closure. Thirty-four of the patients were over the age of 50 (65.4%), with an average age of 56.7 years. The average BMI of the population was 32.1, with 5 patients < 25 kg/m2 (9.6%), 16 patients 25 – 29.9 kg/m2 (30.7%), 15 patients 30 – 34.9 kg/m2 (28.8%) and 16 patients > 35 kg/m2 (30.7%). Forty-seven of the patients had ventral hernias (90.4%), 43 were incisional (82.7%), 5 were umbilical (9.6%), and 2 were inguinal (3.8%). Thirty-one of the patients were being treated for recurrent hernias (59.6%). The average surgery lasted 4.46 hours, and the average stay was 3.9 days, with 8 patients requiring readmission (15.4%). Post-operatively, 4 patients' recoveries were complicated by seroma (7.7%), 5 by hematoma (9.6%), 8 by infection (15.4%), 1 by ileus (1.9%), 3 required removal of mesh (5.8%), and 2 experienced recurrent hernias (3.8%), both secondary to post-operative infection.
Conclusion: The outcomes of this data series suggests Phasix is a reliable mesh for complex and recurrent hernia repair with a low recurrence and complication rate.