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Open Access
CC BY 4.0 · J Reconstr Microsurg 2026; 42(01): 044-052
DOI: 10.1055/a-2555-2348
Original Article

Abdominal Wall Reinforcement Using OviTex after Deep Inferior Epigastric Perforator Flap

Authors

  • Alec S. McCranie 

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

  • Caitlin Blades

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

  • Steven Dawson

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

  • Jose A. Foppiani

    2   Department of Plastic and Reconstructive Surgery, Beth Isreal Deaconess Medical Center, Boston, Massachusetts

  • Taylor Allenby

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

  • Julian Winocour

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

  • Justin Cohen

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

  • David Mathes 

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado

  • Christodoulos Kaoutzanis 

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Abstract

Background

Abdominal wall bulges and hernias are not uncommon complications following deep inferior epigastric perforator (DIEP) flap harvest. Abdominal wall reinforcement using synthetic meshes has been found to decrease bulges by up to 70%; however, such meshes can be associated with other issues such as seromas and infections. Reinforced tissue matrix (RTM) mesh can be used for abdominal wall reinforcement due to its ability to recruit fibroblasts and provide a scaffold for cellular proliferation. There is no literature on the use of OviTex mesh for abdominal wall reinforcement following DIEP flap harvest. Therefore, this study aimed to evaluate the efficacy and safety of its use in this setting.

Methods

A retrospective review was performed on patients undergoing DIEP flap harvest between January 2020 and June 2023. Patients who had completed at least 12 months of follow-up visits were included. Descriptive, univariate, and multiple logistic regression analyses were completed.

Results

A total of 199 patients were included. The mean age at the time of surgery was 51.1 ± 10.0 years and the mean body mass index (BMI) was 30.2 ± 5.9 kg/m2. Abdominal wall reinforcement was completed in 85 (42.7%) patients. Patients who had OviTex placed developed fewer bulges compared to the non-mesh cohort (0% vs. 5.3%, p = 0.04). Furthermore, OviTex mesh did not increase adverse events and was not significantly different in seroma/hematoma rates when compared to the non-mesh cohort (10.6% vs. 5.3%, p = 0.26).

Conclusion

This study demonstrates that OviTex mesh is safe and efficacious in reducing the rate of bulges following DIEP flap harvest without increasing other complications.

Keywords

deep inferior epigastric perforator flap - mesh - breast reconstruction - hernia - bulge

Note

Poster presentation at the American Society of Reconstructive Microsurgery Annual Meeting, January 13, 2024.

Oral presentation at the Mountain West Society of Plastic Surgery Annual Meeting, March 8, 2024.




Publication History

Received: 24 November 2024

Accepted: 19 February 2025

Accepted Manuscript online:
11 March 2025

Article published online:
01 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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