Use of biological mesh in facilitation of early closure in potentially infected abdominal wall defects.

INTRODUCTION Abdominal wall defects with exposed bowels present a significant risk of iatrogenic and spontaneous intestinal fistulation, and early wound closure is warranted. We describe our experience with the use of biological mesh (BM) for facilitation of secondary abdominal wall closure in patients with abdominal wall defects after severe complications, including surgically inaccessible enteric fistulas. MATERIAL AND METHODS The present study is a prospective cohort study comprising ten patients with abdominal wall defects treated with BM. At reconstructive surgery with BM, six patients had stomas, four had wounds complicated by intestinal fistulas and three had both. RESULTS In five cases, the abdominal wall was closed without complications. The remaining five patients had unsuccessful primary healing of the skin, but all subsequently healed by granulation on the mesh. In two cases, BM was implanted directly on exposed bowel with inaccessible fistulas still present. Patients were discharged a median of 15 days (6-35 days) after insertion of the BM. The median follow-up was 11 months (1.5-18.5 months). Only one patient developed a hernia. CONCLUSION BM can be used in contaminated defects, even when primary skin closure is not achieved, or with fistulas still present causing continuous contamination of the surgical site and mesh. BM facilitates early closure of the abdomen. FUNDING not relevant. TRIAL REGISTRATION not relevant.