Prospective repair of Ventral Hernia Working Group type 3 and 4 abdominal wall defects with condensed polytetrafluoroethylene (MotifMESH) mesh Jennifer.

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Prospective repair of Ventral Hernia Working Group type 3 and 4 abdominal wall defects with condensed polytetrafluoroethylene (MotifMESH) mesh Jennifer E. Cheesborough, M.D., Jing Liu, M.D., Derek Hsu, B.A., Gregory A. Dumanian, M.D., F.A.C.S. The American Journal of Surgery Volume 211, Issue 1, Pages 1-10 (January 2016) DOI: 10.1016/j.amjsurg.2015.03.033 Copyright © 2016 The Authors Terms and Conditions

Figure 1 (A–D) A 37-year-old male with a 12-cm incisional hernia following a gastric pull-up procedure and open abdominal wounds. He was treated with bilateral components releases, intra-abdominal cPTFE hernia repair, and excision of the thinned skin and abdominal wounds. The American Journal of Surgery 2016 211, 1-10DOI: (10.1016/j.amjsurg.2015.03.033) Copyright © 2016 The Authors Terms and Conditions

Figure 2 (A) Preoperative photo of a 76 year old with a massive hernia, loss of domain, and right colon cancer. (B) Preoperative CT scan of hernia with loss of domain. (C) Intraoperative photo after right colectomy (D) Intra-abdominal cPTFE (MotifMESH) partially inset with transrectus abdominal sutures placed. (E) Direct supported repair. Note the minimized skin elevation with preservation of soft tissue and skin perforators to maintain skin vascularity. (F) Postoperative photo 1 year after the procedure. (G) Postoperative CT scan 1 year after the procedure. The cPTFE mesh can be seen as a faint white line behind the rectus muscles. The American Journal of Surgery 2016 211, 1-10DOI: (10.1016/j.amjsurg.2015.03.033) Copyright © 2016 The Authors Terms and Conditions

Figure 3 (A) A 39-year-old female with Crohn’s disease, diverting ileostomy, and midline ventral hernia. (B) One-year postoperative photo after cPTFE direct supported repair. The American Journal of Surgery 2016 211, 1-10DOI: (10.1016/j.amjsurg.2015.03.033) Copyright © 2016 The Authors Terms and Conditions

Figure 4 (A) CT scan 7 months after placement of cPTFE demonstrating wrinkling and perimesh fluid. (B) Intraoperative photograph of removal of infected cPTFE in a prior transverse rectus abdominis myocutaneous flap donor site. The mesh is wrinkled. A fibrous rind exists on the deep aspect of the cavity to contain the viscera. (C) The explanted MotifMESH. Note the lack of tissue ingrowth. The American Journal of Surgery 2016 211, 1-10DOI: (10.1016/j.amjsurg.2015.03.033) Copyright © 2016 The Authors Terms and Conditions

Figure 5 Patient-reported outcomes for fatigue, movement, and overall sense of well-being before and 1 year after surgery on a 10-point scale. The American Journal of Surgery 2016 211, 1-10DOI: (10.1016/j.amjsurg.2015.03.033) Copyright © 2016 The Authors Terms and Conditions

Figure 6 Patient-reported outcome for pain using a 10-point visual analog scale vs time from the procedure. The American Journal of Surgery 2016 211, 1-10DOI: (10.1016/j.amjsurg.2015.03.033) Copyright © 2016 The Authors Terms and Conditions