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Use of Composite Grafts in Abdominal Sacrocolpopexy

Skoczylas, Laura C. MD*; Lane, Felicia L. MD†; Noblett, Karen L. MD†

Female Pelvic Medicine & Reconstructive Surgery: January/February 2011 - Volume 17 - Issue 1 - pp 40-43
doi: 10.1097/SPV.0b013e3181f591bd
Case Series

Objective: The ideal graft material for pelvic reconstructive surgery remains undetermined. The purpose of this study was to present data on novel composite biologic/synthetic grafts during use in abdominal sacrocolpopexy.

Methods: A case series of 90 patients undergoing abdominal sacrocolpopexy with composite biologic/synthetic grafts was conducted. The primary outcome was graft erosion. Assuming a 3% risk of reoperation for mesh erosion, the number needed to treat with a composite graft in order to avoid erosion risk from a synthetic-only graft was calculated. The cost of a composite graft was compared to reoperation costs for mesh erosion of a synthetic-only graft.

Results: Zero patients (N = 90) undergoing abdominal sacrocolpopexy with a composite biologic/synthetic graft experienced graft erosion. Based on existing data, thirty-three patients would need to be treated with a composite graft to avoid one mesh erosion from a synthetic-only graft. If a $500 composite graft is used, the cost of reoperation performed abdominally is higher.

Conclusions: This study introduces a novel biologic/synthetic composite graft that offers the advantage of low erosion risk during use in abdominal sacrocolpopexy. Combined grafts may also be cost-effective. Future research should focus on exploring the role of these durable, yet low erosion risk grafts to potentially promote improved safety for our patients and cost savings for society.

A novel biologic/synthetic composite graft is introduced that offers the advantage of low erosion risk during use in abdominal sacrocolpopexy.

From the *Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA; and †Division of Urogynecology, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, CA.

Reprints: Laura C. Skoczylas, MD, Department of Obstetrics and Gynecology, Magee-Womens Hospital, 300 Halket St, Pittsburgh, PA 15213. E-mail: skoczylaslc@mail.magee.edu.

All data collection and analysis was performed at the University of California, Irvine, Orange, CA.

© 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins