Fox Chase Researcher Finds Dissolvable Mesh Prevents Complications at Abdominal Donor Site After Breast Reconstruction

February 20, 2020

Neal S. Topham, MD, FACSNeal S. Topham, MD, FACS

PHILADELPHIA (February 20, 2020) — A surgeon at Fox Chase Cancer Center pioneering the use of a new resorbable mesh to minimize the risk of hernias and bulges after bilateral flap breast reconstruction has published positive two-year results.

“For this breast reconstruction we harvest tissue from the abdominal wall and transfer it to the breast,” said Neal S. Topham, MD, FACS, chief of Plastic and Reconstructive Surgery at Fox Chase. “When the patient’s abdomen is closed, some surgeons will close using sutures, but that method may result in bulges or hernias.”

Instead, mesh can be used to reinforce the abdominal wall. Historically, a polypropylene mesh has been used. However, these polypropylene mesh supports are permanent and pose additional risk for subsequent infection.

In a recent study, the first to investigate the optimal type of mesh to use, Topham and colleagues at another center compared the use of sutures, polypropylene mesh, and the new resorbable mesh, Phasix, at the abdominal site for free flap reconstruction.

“This new mesh dissolves,” Topham said. “It acts like a temporary splint while the abdominal tissues heal and then disappears.”

Looking back at 66 patients who underwent bilateral flap breast reconstruction, six patients were closed using sutures, 20 with polypropylene mesh, and 40 with resorbable mesh. The patients were followed for a minimum of two years.

Use of the resorbable mesh resulted in higher initial operative costs compared with the other two methods, but resulted in a lower rate of early wound complications and no long-term abdominal bulges or hernias.

“Even though initially this material may be more expensive, there is money saved by using it because of the decreased seroma rate, the decrease in bulge, and the decrease in return to the operating room for repair of bulge,” Topham said. “It provides a stronger repair of the abdominal wall that stays in place until the natural tissue can once again support it.”

The paper, “Comparison of Phasix, Polypropylene, and Primary Closure of the Abdominal Donor Site After Bilateral Free Flap Breast Reconstruction: Long-Term Evaluation of Abdominal Hernia and Bulge Formation,” was published in Microsurgery.

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence five consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.


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