Comparative long-term effectiveness between ventral hernia repairs with biosynthetic and synthetic mesh

Area of Science:

• Abdominal surgery
• Biomaterials science
• Surgical outcomes research

Background:

• Ventral hernia repair (VHR) involves a debate on optimal mesh selection, with synthetic and biologic options having distinct pros and cons.
• Biosynthetic mesh, a newer option, combines characteristics of both synthetic and biologic meshes.
• This study compares long-term hernia recurrence rates between biosynthetic and synthetic mesh in VHR.

Approach:

• A retrospective review of consecutive VHR cases (2013-2018) was conducted.
• Data included patient demographics, perioperative characteristics, wound class, comorbidities, mesh type, hernia defect size, and postoperative events.
• Kaplan-Meier analysis and Cox regression were used to assess repair longevity and recurrence.

Key Points:

• Biosynthetic mesh was used in 23% of cases (n=101), and synthetic mesh in 77% (n=338).
• Patients receiving biosynthetic mesh were older and had higher rates of comorbidities and prior abdominal infections.
• Kaplan-Meier analysis revealed no significant difference in hernia recurrence between the two mesh types, with 5-year recurrence-free survival at approximately 72% for both.

Conclusions:

• Both synthetic and biosynthetic mesh demonstrate comparable hernia recurrence rates in abdominal wall reconstruction.
• Surgical site infection rates were also similar between the two mesh types.
• Long-term follow-up (up to five years) supports the equivalent efficacy of biosynthetic and synthetic mesh in VHR.