What Mesh Should be Used in Hernia Repair?

Area of Science:

• General Surgery
• Surgical Innovation
• Biomaterials Science

Background:

• Ventral hernia repair is a common general surgery procedure.
• Treatment of contaminated ventral hernias with mesh remains controversial.
• Biologic mesh is often favored for contaminated cases due to perceived infection resistance.

Purpose of the Study:

• To provide a comprehensive review of mesh selection for single-staged, open ventral hernia repair.
• To evaluate mesh options in both clean and contaminated surgical settings.
• To analyze tissue incorporation, cost, safety, complications, recurrence, and long-term outcomes of different meshes.

Main Methods:

• Comprehensive literature review.
• Analysis of existing studies on ventral hernia repair using various mesh types.
• Evaluation of data on mesh characteristics, clinical outcomes, and cost-effectiveness.

Main Results:

• Biologic mesh is frequently used in contaminated ventral hernia repairs.
• Discussion of mesh properties including tissue incorporation, infection resistance, and complication rates.
• Comparison of different mesh types regarding recurrence and long-term patient outcomes.

Conclusions:

• Mesh choice in ventral hernia repair, particularly for contaminated cases, requires careful consideration.
• Biologic meshes offer potential benefits in reducing complications and reoperations.
• Further research and evidence are needed to optimize mesh selection for diverse patient populations and contamination levels.