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Poly-4-hydroxybutyrate Mesh for Ventral Hernia Repairs: A Single-Surgeon Experience
Cody C Fowler1, Kevin M Klifto2, Larissa E Wietlisbach3
1Division of Plastic Surgery, Department of Surgery, University of Rochester, Rochester, New York.
Eplasty
|September 4, 2023
Summary
Poly-4-hydroxybutyrate (P4HB) mesh offers acceptable recurrence rates and favorable complication risks for ventral hernia repair (VHR). Key recurrence predictors include prior VHR, hypertension, and immunosuppression.
Area of Science:
- Biomaterials Science
- Surgical Innovation
- Hernia Repair Techniques
Background:
- Poly-4-hydroxybutyrate (P4HB) biosynthetic mesh (Phasix) is a novel option for ventral hernia repair (VHR).
- Limited outcome data exist for P4HB mesh in VHR.
- This study evaluates VHR outcomes using P4HB mesh.
Purpose of the Study:
- To analyze the outcomes of ventral hernia repair (VHR) using P4HB mesh.
- To identify predictors of postoperative outcomes in VHR with P4HB mesh.
Main Methods:
- Retrospective study of adult patients undergoing open VHR with P4HB mesh (2014-2020).
- Minimum follow-up of 12 months.
- Subgroup comparisons and multivariate logistic regression analysis.
Main Results:
- 169 patients with a median follow-up of 15 months.
- Surgical site occurrences: 21.9%; Reoperations: 17.8%; Recurrences: 4.7%.
- Predictors of recurrence: hypertension (OR=13.64), immunosuppression (OR=42.57), and prior VHR (OR=20.20). Prior mesh infection increased subsequent infection risk (6.5% vs 0.7%).
Conclusions:
- VHR with P4HB mesh demonstrates acceptable recurrence rates and favorable complication profiles.
- Hypertension, immunosuppression, and prior VHR are significant predictors of recurrence.
- Prior mesh infection increases risk of subsequent infection but not reoperation.
