Slowly absorbable mesh in contaminated incisional hernia repair: results of a French multicenter study

Area of Science:

• Surgical Innovation
• Biomaterials in Surgery
• Hernia Repair Techniques

Background:

• Incisional hernia repair in contaminated fields poses high risks of surgical site infections and recurrence.
• Traditional mesh materials may be associated with increased complications in such environments.
• Biosynthetic, long-term absorbable meshes offer a potential alternative for complex hernia repairs.

Purpose of the Study:

• To evaluate the safety and efficacy of a biosynthetic long-term absorbable mesh (Phasix®) for incisional hernia repair.
• To analyze postoperative morbidity and 1-year recurrence rates in patients with contaminated surgical fields.
• To assess outcomes in patients classified by the modified Ventral Hernia Working Group (mVHWG) classification.

Main Methods:

• Retrospective cohort study of 215 patients undergoing incisional hernia repair with Phasix® mesh in contaminated fields.
• Patients were classified using the mVHWG classification.
• Data collected included surgical site infections (SSIs), surgical site occurrences (SSOs), complications (Dindo-Clavien), and recurrence rates over 1 year.

Main Results:

• The study included 170 patients (79%) with mVHWG grade 3 and 45 (21%) with grade 2.
• Postoperative SSI and SSO rates at 12 months were 22.3% and 39.5%, respectively.
• The 1-year clinical recurrence rate was 12.4% among 121 patients with follow-up. Concomitant gastrointestinal procedures and emergency settings were risk factors for infection and major complications, respectively.

Conclusions:

• Biosynthetic absorbable mesh (Phasix®) demonstrates safety in contaminated surgical fields for incisional hernia repair.
• Satisfactory immediate postoperative and 1-year outcomes were observed.
• The mesh is a viable option for high-risk patients in challenging surgical environments.