Xen Matrix™ AB Surgical Graft in Ventral or Incisional Midline Hernias

Study Overview
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Brief Summary
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This study aims to prospectively explore the use of XenMatrix™ AB Surgical Graft for ventral or incisional midline hernia repair in patients across all wound classes (All Comers) through 24 months post repair.

Detailed Description
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This is a post-market, on-label study to understand the performance of the graft in the US.

Official Title
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A Post-Market, Prospective, Multicenter, Single-Arm Trial of XenMatrix™ AB Surgical Graft in All Wound Classes Ventral or Incisional Midline Hernias

Conditions
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Incisional Hernia

Intervention / Treatment
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* Device: Xen Matrix AB


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subject must be willing and able to give written informed consent. Subject must be diagnosed with a ventral or incisional midline hernia. Mesh must be placed in the retro-rectus or intraperitoneal plane. Subject must be willing to undergo open hernia repair and be able to undergo all other study procedures as outlined in this protocol. Exclusion Criteria: The use of surgical graft as a bridge repair. The subject has more than 4 prior recurrences. Subject has a contraindication for the placement of surgical graft. Complete removal of existing mesh from a prior hernia repair (in the same affected area) is not possible. The study hernia repair requires more than a single piece mesh (including sufficient overlap beyond margins of the defect on all sides). Subject has intact permanent mesh adjacent to the current hernia to be repaired. Subject has peritonitis at the time of surgery. The subject is an active smoker within the last 2 weeks prior to surgery. Clinically significant Chronic Obstructive Pulmonary Disease or heart failure, defined as marked limitation in ability or inability to perform activities of daily living. Subject had chemotherapy within the last 12 months, is on or suspected to be placed on chemotherapy medications during any part of the study. Chronic steroid use (>6 months) or immunosuppression drugs. Subject's body mass index (BMI) >45 kg/m2. Subject has cirrhosis, and/or ascites. Subject has a defined collagen disorder. Known to be infected with human immunodeficiency virus (HIV). Subject has clinically significant (not based solely on creatinine levels) kidney disease that limits Activities of Daily Living, is on hemodialysis or peritoneal dialysis. Subject is American Society of Anesthesiology (ASA) Class 4 or 5. Subject has a life expectancy < 2 years at the time of enrollment. Subject is pregnant, breastfeeding or planning on becoming pregnant during the course of the study. Subjects with known sensitivity to porcine products. Subjects with allergy, history of allergy or hypersensitivity to tetracyclines (including minocycline) or rifamycins (including rifampin). Subject has any condition in the opinion of the Investigator that would preclude the use of the study device, or preclude the subject from completing the follow-up requirements.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Xen Matrix AB<br>Subjects treated with Xen Matrix AB | Device: Xen Matrix AB<br>* Xen Matrix™ AB Surgical Graft is an acellular, sterile, non-pyrogenic porcine dermal matrix packed dry for use in the reconstruction of soft tissue deficiencies. The device surfaces are coated with the antibacterial agents Rifampin and Minocycline in a bioresorbable L-Tyrosine succinate polymer carrier.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Wound Occurrences Up to 45 Days Post Implantation | Wound occurrences were defined as surgical site infection, seroma, wound dehiscence, skin necrosis and fistulas requiring intervention. | Up to 45 days post implantation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Wound Occurrences > 45 Days Post Implantation | Wound occurrences was defined as surgical site infection, seroma, wound dehiscence, skin necrosis and fistulas requiring intervention. | Day 45 and up to 2 years post implantation | 
| Number of Participants With Hernia Recurrence Within 6 Months and 24 Months of Implantation Procedure |  | Within 6 months and 24 months of implantation procedure | 
| Number of Participants With Reoperation Due to Index Hernia Repair |  | 24 months post implantation procedure | 
| Total Score on the Carolinas Comfort Scale (CCS) at Baseline, 1, 3, 6, 12, 18, and 24 Months Post Implantation Procedure | The Carolinas Comfort Scale (CCS) quality of life questionnaire aimed for patients who have had hernia repair surgery. Symptoms in the CCS are rated by the participants on a scale of 0 to 5, with a score of 0 suggesting no symptoms and a score of 5, disabling symptoms. A lower score on the questionnaire compared to baseline would indicate a better outcome. | Baseline, 1, 3, 6, 12, 18, and 24 months post implantation procedure | 
| General Health Score on the Short Form 12 (SF-12) Questionnaire at Baseline, 1, 3, 6, 12, 18, and 24 Months Post Implantation. | The Short Form 12 (SF-12) is a self-reported 12-item questionnaire that evaluates general health and well-being (overall quality of life of an individual). The SF-12 includes questions on physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Scores range from 0 to 100, with higher scores indicating better levels of functioning. | Baseline, 1, 3, 6, 12, 18, and 24 months post implantation | 
| Number of Participants Who Returned to Work Post Implantation Procedure |  | Up to 2 years following implantation procedure | 
| Duration of Participants Stay in Hospital Following Implantation Procedure |  | From index procedure day to discharge from hospital day |