Open components separation and underlay repair using biological mesh for the treatment of planned ventral hernia after open abdomen surgery

Objective: There are no standard surgical methods for planned ventral hernia (PVH). This paper discusses the possibility of using “open components separation + underlay repair using biological mesh” as a preferred surgical method for PVH. Methods: We retrospectively analyzed the clinical data of PVH patients who received open components separation and underlay repair using biological mesh. Results: Five PVH patients underwent this surgical method from June 2014 to April 2015. All patients were males with an average age of 43.6 ± 17.3 years, body mass index (BMI) of 23.1 ± 2.3 kg/m2, and skin graft width of 15-17 cm. Four patients received a sliding myofascial flap of bilateral musculus rectus abdominis + underlay repair with biological mesh (Biodesign®, Cook Medical, Inc., Bloomington, IN, USA), and 1 patient received a sliding myofascial flap of unilateral musculus rectus abdominis + underlay repair with biological mesh. There was one case of incisional infection and 1 case of abdominal sinus formation 2 weeks after discharge. Both patients were cured using vacuum sealing draining (VSD) for 4 to 5 months without removal of the biological meshes. Five patients were followed up in an outpatient clinic after discharge, and the follow-up time ranged from 13 to 23 months. Abdominal incisions healed well, and abdominal computed tomography (CT) indicated no hernia recurrence in all patients. Conclusions: The “open components separation + underlay repair using biological mesh” method is a safe and feasible treatment method for PVH with good outcomes.