Case Report: Synthetic mesh failure and biological mesh salvage in major oncologic abdominal wall reconstruction—a two-case series with technical considerations
- 1College of Medicine, Alfaisal University , ,
- 2Surgical Oncology Department, Cancer Centre of Excellence, King Faisal Specialist Hospital & Research Centre , ,
Abstract
Background and objectives: Abdominal wall reconstruction after major oncologic resection is challenging, particularly when the operative field has been compromised by radiation, extensive tissue loss, and, in some cases, intraperitoneal chemotherapy. Mesh choice is central to minimizing complications and achieving durable outcomes. This report describes the clinical course of two patients who underwent initial synthetic mesh reconstruction and subsequently required biological mesh salvage, both managed at a single tertiary referral center.
Methods: Two patients who underwent anterior abdominal wall reconstruction following major oncologic resection were retrospectively reviewed. Both initially received synthetic mesh (expanded polytetrafluoroethylene [ePTFE, Gore-Tex®] in Case 1; polypropylene-based mesh in Case 2). After developing mesh-related complications, both underwent reoperation with biological mesh (Permacol™ Surgical Implant, Covidien) placed in an underlay position with primary fascial closure.
Results: Both patients developed recurrent surgical site infections, mesh protrusion, and bowel adhesions that required multiple interventions following synthetic mesh placement. After reconstruction with biological mesh, infection resolved and abdominal wall integrity was restored, with no further mesh-related complications at 12 months of follow-up in each case.
Conclusion: These cases show how synthetic mesh can fail in the compromised field of major oncologic abdominal wall reconstruction, and suggest that mesh choice should be matched to the extent and contamination risk of the resection, with biological mesh a reasonable option when the field is heavily compromised. The findings are hypothesis-generating and should not be generalized. Prospective studies are needed to establish mesh selection criteria in this setting.
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BibTeX
@article{saeed2026case,
title = {{Case Report: Synthetic mesh failure and biological mesh salvage in major oncologic abdominal wall reconstruction—a two-case series with technical considerations}},
author = {Ismail Saeed and Khalid Osama Alnajjar and Ali H. Alfuraydi and Ayman Zaki Azzam and Ihssan Alalem},
journal = {Frontiers in surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1936273},
url = {https://europepmc.org/article/PMC/PMC13727588},
note = {CC BY},
}
RIS
TY - JOUR
TI - Case Report: Synthetic mesh failure and biological mesh salvage in major oncologic abdominal wall reconstruction—a two-case series with technical considerations
AU - Ismail Saeed
AU - Khalid Osama Alnajjar
AU - Ali H. Alfuraydi
AU - Ayman Zaki Azzam
AU - Ihssan Alalem
PY - 2026
DA - 2026/10/20
JO - Frontiers in surgery
DO - 10.3389/fsurg.2026.1936273
UR - https://europepmc.org/article/PMC/PMC13727588
AB - Background and objectives: Abdominal wall reconstruction after major oncologic resection is challenging, particularly when the operative field has been compromised by radiation, extensive tissue loss, and, in some cases, intraperitoneal chemotherapy. Mesh choice is central to minimizing complications and achieving durable outcomes. This report describes the clinical course of two patients who underwent initial synthetic mesh reconstruction and subsequently required biological mesh salvage, both managed at a single tertiary referral center. Methods: Two patients who underwent anterior abdominal wall reconstruction following major oncologic resection were retrospectively reviewed. Both initially received synthetic mesh (expanded polytetrafluoroethylene [ePTFE, Gore-Tex®] in Case 1; polypropylene-based mesh in Case 2). After developing mesh-related complications, both underwent reoperation with biological mesh (Permacol™ Surgical Implant, Covidien) placed in an underlay position with primary fascial closure. Results: Both patients developed recurrent surgical site infections, mesh protrusion, and bowel adhesions that required multiple interventions following synthetic mesh placement. After reconstruction with biological mesh, infection resolved and abdominal wall integrity was restored, with no further mesh-related complications at 12 months of follow-up in each case. Conclusion: These cases show how synthetic mesh can fail in the compromised field of major oncologic abdominal wall reconstruction, and suggest that mesh choice should be matched to the extent and contamination risk of the resection, with biological mesh a reasonable option when the field is heavily compromised. The findings are hypothesis-generating and should not be generalized. Prospective studies are needed to establish mesh selection criteria in this setting.
SN - 2296-875X
ER -