SRS353 - Can plasma procollagen levels predict incisional hernia recurrence following surgical repair?

Abstract Introduction Rates of recurrence following incisional hernia repair remain high. Defective wound healing is thought to contribute to this. The aim of this study was to compare plasma concentrations of target biomarkers between patients who developed or remained free from hernia recurrence following surgical repair. Methods A panel of biomarkers was selected based on their involvement in tissue repair processes; pro-collagen I, pro-collagen III, TGFb, fibronectin, MMP-2, MMP-9, TIMP-1, and TIMP-2. A cohort of patients within a randomised trial that underwent primary incisional hernia repair were bled prior to surgery and at four post-operative time points up to one year. The plasma concentrations of chosen biomarkers was calculated and compared between those who developed (n = 4) or remained free (n = 18) from hernia recurrence. Results Individual biomarker signatures were observed. In patients who developed incisional hernia recurrence, lower levels of procollagen I were detected at preoperative day0 (median 911 462 versus 1 195 259, P = 0.019) and post-operative day1 (520 313 versus 952 347, P = 0.024) and day6 (653 348 versus 992 027, P = 0.005), with a significantly higher level of procollagen III at preoperative day0 (9804 versus 6350, P = 0.026) and post-operative day1 (9372 versus 6271, P = 0.007), day6 (8320 versus 6412, P = 0.050) and day30 (9703 versus 6881, P = 0.027). For the other assayed biomarkers, there were no significant differences between the groups at all timepoints. Conclusions Low procollagen I and high procollagen III plasma concentrations may predict risk of incisional hernia recurrence. This finding, if ratified, could impact preoperative counselling, preoptimization and chosen surgical techniques to reduce the future burden of incisional hernia.