Complex Ventral Hernia Repair Using Biologic or Synthetic Mesh (CVHR)

This is an interventional treatment trial for Hernia, Ventral focused on measuring Hernia, Ventral, Incisional, Abdominal, Herniorrhaphy, Recurrence, Infection, Mesh, Biologic, Synthetic Read More

Inclusion Criteria:

• Clinical evidence of a midline, ventral hernia, regardless of degree of wound contamination, with the exception of class IV wounds due to the presence/discovery of fecal peritonitis. Specifically, the repair will or will not involve a compromised surgical field in which gastrointestinal, biliary and/or genitourinary procedures will be performed. The surgical wound class may be classified as clean, or it may be classified as clean-contaminated, contaminated, or dirty-infected, due to the repair of an enterocutaneous fistula, takedown of an intestinal stoma and/or removal of infected mesh
• Age >21
• Negative pregnancy test
• No allergic, religious or ethical objections to either polypropylene or porcine prosthetics
• Signed, witnessed informed consent to take part in the study

Exclusion Criteria:

• Lactating women
• Patients who are unable to commit to the follow evaluations over 24 months
• Severe malnutrition (serum albumin <2.0 in the setting of a normal CRP)
• Use of an investigational agent within 1 month prior to study enrollment and/or planned during this study
• Presence of pre-existing parenchymal liver disease characterized by the presence of Child's Class C liver dysfunction (including all of the following: bilirubin ≥ 3.0 mg/dL; albumin ≤ 3.0 mg/dL; refractory ascites; encephalopathy or coma; and poor nutritional status)
• Immunocompromised patients, as evidenced by: administration of high doses of corticosteroids (i.e. doses ≥ 1.5 mg/kg/day of prednisone or equivalent) within 72 hours before study enrollment; status post solid organ transplant or bone marrow transplant and experiencing acute organ rejection or bone marrow failure or rejection; evidence of neutropenia (absolute neutrophil count ≤ 500 cells/mm3 (≤ 500 x 106 cells/L); chemotherapy or radiation therapy within 90 days before study enrollment; known AIDS; any disease sufficiently advanced to suppress resistance to infection (including, but not limited to leukemia, lymphoma or hypogammaglobulinemia); administration of immunoglobulin of G-CSF within 90 days before study enrollment
• Ascites refractory to medical management
• Presence of an underlying disease/injury with life expectancy less than two years and/or severe underlying disease that would preclude study entry (e.g. known malignancy)
• Wound Classification IV due to the presence/discovery of fecal peritonitis. Other cases of wound class IV including presence of purulent inflammation, soft tissue/mesh infection, or visceral perforation resulting in a contained fistula (e.g. enterocutaneous fistula) are still considered eligible for enrollment.