Prospective study of single-stage repair of contaminated hernias with the novel use of calcium sulphate antibiotic beads in conjunction with biologic porcine submucosa tissue graft

Prospective study of single-stage repair of contaminated hernias with the novel use of calcium sulphate antibiotic beads in conjunction with biologic porcine submucosa tissue graft

Can J Surg 2020;63(6):E530-E532 | PDF

Ashley Drohan, MD; Sam Minor, MD

Summary

In single-stage hernia repair in the setting of contaminated fields there is a high rate of infection following mesh repair. New strategies to decrease infection in this challenging patient population are needed. Stimulan calcium sulfate antibiotic beads (CSAB) are a biodegradable material that deliver high concentrations of antibiotics locally to a site of insertion. Their use in the prevention of infection has not been described in hernia graft implantation. Here we describe our use of CSAB in a series of 11 patients with modified Ventral Hernia Working Group class III and Centers for Disease Control and Prevention class II–IV wounds undergoing single-stage incisional ventral hernia repair. We found that implantation of CSAB in single-stage hernia repair in the setting of contaminated fields was feasible with low systemic antibiotic levels. Further research should be undertaken to investigate the efficacy of this novel tool in hernia repair.


Accepted Jan. 20, 2020

Affiliations: From the Department of Surgery, Dalhousie University, Halifax, NS.

Competing interests: S. Minor declares research support from Cook Medical for a different trial: “AMEX” hernia device, as well as speaker honorarium from Cook Medical. No other competing interests were declared.

Contributors: Both authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.021819

Correspondence to: S. Minor, Department of Surgery, Dalhousie University, Rm 813 Victoria Bldg, Victoria General Hospital, QEII Health Sciences Centre, Halifax NS B3H 2Y9, samuel_minor@hotmail.com