Impact of pericardium bovine patch (Tutomesh^®) on incisional hernia treatment in contaminated or potentially contaminated fields: retrospective comparative study

Purpose: This retrospective comparative study analyzes the outcome of patients affected by incisional hernia in potentially contaminated or contaminated field, treated by three operative techniques. Methods: 152 patients (62 M:90 F; mean age 65 ± 14 years) underwent incisional hernia repair (January 2002–January 2012) in complicated settings. Criteria of inclusion in the study were represented by the following causes of admission: mesh rejection/infection, obstruction without gangrene but with possible peritoneal bacterial translocation, obstruction with gangrene, enterocutaneous fistula or simultaneous presence of ileo- or colostomy. The patients were divided into three groups: A (n = 76), treated with primary closure technique; B and C (n = 38 each), with reinforcement by synthetic or pericardium bovine mesh (Tutomesh^®), respectively. The prosthetic groups were divided into Onlay and Sublay subgroups. Results: Significant decreases in C vs A were observed for wound infection (3 vs 37 %) and recurrence (0 vs 14 %), and in C vs B for wound infection (3 vs 53 %), seroma (0 vs 34 %) and recurrence (0 vs 16 %). Patients with concomitant bowel resection (BR) (43 %) showed (all P