Bovine versus porcine acellular dermal matrix for abdominal wall herniorrhaphy or bridging

Kathryn Van Orden, Jeffrey Santos, Brent Stanfield, Landon S. Frost, Alexander Ruditsky, Andrea Foster, Tejal S. Brahmbhatt, Peter A. Burke, Joseph Fernandez-Moure, Krista Haines, Suresh Agarwal, George Kasotakis*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: The management of complicated ventral hernias (CVH), namely ventral hernias in actively or recently infected/contaminated operative fields, and open abdomens in which the native fascia cannot be primarily reapproximated, pose a surgical challenge. Fetal Bovine and Porcine Acellular Dermal Matrix (BADM and PADM) biologic meshes are being increasingly used in these scenarios. A comparison, however, of clinically relevant outcomes between the two is lacking. With this investigation, we aim to review and compare clinically relevant outcomes in patients that underwent abdominal wall herniorrhaphy with either BADM or PADM at a tertiary urban academic institution over a 5-year period. Methods: Patients who had a BADM or PADM implanted during CVH over a 5-year period at a tertiary urban academic hospital were identified. Baseline clinical and hernia characteristics, as well as postoperative outcomes were compared after a retrospective chart review. Phone interviews were also conducted to assess for recurrence, followed by in-person visits as indicated. Cox Proportional Hazard regression was fitted to identify risk factors for recurrence. Results: Of the 140 patients who underwent biologic mesh implantation for CVH, 109 were for ventral hernia repair and 31 for open abdomen bridging. Mean age was 52.7 ± 14.2 and males constituted 57.9% of our sample, while 25.1% had undergone > 5 prior abdominal operations. Thirty percent were active smokers, and another 30% required emergency surgery. Only immunosuppression was a risk factor for recurrence [HR 13.3 (1.04–169.2), p = 0.047] on Cox Proportional Hazard regression, while mesh selection had no effect. Conclusions: Both BADM and PADM meshes perform well in CVH, with satisfactory recurrence rates, only slightly higher compared to traditional synthetic mesh repairs.

Original languageEnglish
Pages (from-to)1993-2001
Number of pages9
JournalEuropean Journal of Trauma and Emergency Surgery
Issue number3
StatePublished - Jun 2022
Externally publishedYes


  • Biologic mesh
  • Complicated ventral hernia
  • Hernia recurrence
  • Open abdomen
  • Ventral hernia repair


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