What the Expert's are saying
At this present time we do our own extensive research on this area as I was told from a Medical Professional and on good authority "the medical profession is actually very alert to surgical complications and sadly, investment in research into the area is not regarded as a priority by medical research funding bodies, which seriously hampers our ability to get a true handle on the situation".
PLEASE READ THIS IMPORTANT ARTICLE from the British Medical Journal (BMJ)
Title
Take note those advocating the use of mesh in hernia repairs
Dated 26th June 2009
Abstract - Five years ago I wrote, in addressing the use of mesh in herna repairs, "Inserting an open mesh in a patient is akin to inserting a limpet mine. It may never be hit by a ship but if it is it could sink it. The risk is of infection developing in the mesh latter years during the course of another illness, such as an AP resection which requires the formation of an adjacent colostomy or admission to an ICU for organ dysfunction. In the latter instance the mesh could become an occult nidus of infection that kills the patient"
http://www.bmj.com/cgi/eletters/338/jun23_1/b2321#215740
Professor Philippe E Zimmern Professor of Urology. I actually contacted Professor Zimmern back in August 2008 where he kindly helped me find someone to contact here in the UK, I asked him who can I contact for help on my mesh problems. He suggested I contact Dr Christopher Chapple in Sheffield or Dr Bill Turner in Cambridge. I visited Dr Christopher Chapple and he was extremely understanding and helpful. You can view Professor Zimmern's article here >>>> PDF file format. Article Title: Vaginal Mesh for incontinence and/or prolapse: caution required. "Even if the rates of these devasting complications are fairly low, they are life-changing for the patient, sometimes irreversible and often sources of litigation"
Dr. Richard Miller is a Professor of Surgery, Medical Director, Trauma Intensive Care Unit, Division of Trauma and Surgical Critical Care at Vanderbilt University Medical Center inNashville, Tennessee.
He sees abdominal wall hernia repair patients after they've had complications with synthetic mesh, some made out of Gortex or Marlex.
"The problem with synthetic mesh is as a foreign body the body tries to reject it and encapsulate it. You can bathe it in antibiotics, but the bottom line is that has to be removed and start over again. Because it's a foreign body you have to be a lifelong risk" he tells IB News.
The key to minimizing that risk, Miller believes, is in patient selection.
"Smoking is the worst. I will not operate on a patient who continues to smoke. Diabetes, obesity, malnutrition, all increase the risk of wound infections. I don't use synthetic mesh in any of those patients," he says. Even prior infections increase the risk of a bad outcome.
"It never made sense to put a foreign body in a person to repair abdominal wall reconstructions. "Synthetic mesh, they never feel the same," he says noting that Ethicon worked hard to create a material that didn't have an inflammatory reaction.
For the patients who Miller rejects, a cadaver or pig skin mesh is a better alternative. But there's the cost. "Synthetic may cost $1,000 to $10,000 for biologic mesh. Hospitals decide what material to use based on cost efficiency," he says.
Dr. Miller says hernia repair complications can occur in up to 40 percent of patients, based on his experience that he admits is a "skewed group, obviously".
"They can erode into the bowel, that's a half million dollar problem. They can erode through the abdominal wall and into the skin. I've seen a couple of circumstances when you remove the synthetic mesh the symptoms resolve. And many do fine."
Miller too encourages the establishment of a national database to support his theory of patient selection. Over the next decade he predicts that biologic mesh material will be refined to form a scaffold that incorporates the body's own tissue and allows it to incorporate immediately.
"My goal is to help these patients and a lot have huge problems. I'm not here to bash synthetic mesh but in certain subgroups there is a better alternative. Certainly, absolutely, they should not be used."
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