Synthetic and Biological Mesh for Ventral Hernia Repair Show Similar Wound Complications, Hernia Recurrence

Lorenz WR, Holland AM, Kerr SW, et al. Outcomes of Synthetic and Biologic Mesh in Abdominal Wall Reconstruction: A Propensity-Matched Analysis in Centers for Disease Control and Prevention Class 1 and 2 Wounds. Surgery. 2024; in press.

The choice of synthetic or biologic mesh for reinforcement of ventral hernia repairs remains controversial.

This article reported a propensity score matched comparison of outcomes for patients (n = 519, 173 repaired with biologic mesh) undergoing abdominal wall reconstruction for hernias with CDC class 1 or 2 wounds. Outcomes of interest were rates of wound complications and hernia recurrence; follow up data were available for 2 years for all patients and 33 months for patients repaired with biologic mesh.

Rates of fascial closure, panniculectomy, and use of component separation were similar in both groups; mesh size was similar as well. Biologic mesh was more likely to be used in patients with Class 1 wounds.

Short and long-term rates of wound complications (7%–10%) and hernia recurrence (1.4%–3%) were not significantly different in the comparison groups but hospital lengths of stay, and hospital costs were significantly increased in patients undergoing biologic mesh repairs. Statistical analyses showed that wound complications predicted hernia recurrence and panniculectomy was associated with an increased risk for wound complications.

The authors concluded that short and long-term rates of wound complications and hernia recurrence were similar after abdominal wall reconstructions performed with synthetic or biologic mesh.