Slowly absorbable mesh in sublay ventral hernia repair in contaminated fields

Area of Science:

• Surgical innovation
• Hernia repair techniques
• Biomaterials in surgery

Background:

• Growing evidence supports permanent mesh use in contaminated wounds.
• Indications for slowly absorbable synthetic prostheses are increasingly questioned.
• This study addresses the debate by comparing mesh outcomes in contaminated cases.

Purpose of the Study:

• To compare outcomes of slowly absorbable mesh versus permanent and biologic mesh in contaminated ventral hernia repairs.
• To evaluate surgical site occurrences, infections, readmissions, reoperations, and recurrence rates.
• To determine the efficacy of slowly absorbable mesh in specific surgical contexts.

Main Methods:

• Analysis of the Abdominal Core Health Quality Collaborative (ACHQC) database (2013-2022).
• Inclusion of patients undergoing elective ventral hernia repair in CDC-III operations.
• Propensity score matching to adjust for patient and operative variables between mesh groups.

Main Results:

• No significant differences in 30-day surgical site occurrences, infections, interventions, readmissions, or reoperations between slowly absorbable, permanent, and biologic mesh groups.
• One-year follow-up showed no difference in hernia recurrence rates among the mesh types.
• Slowly absorbable synthetic mesh was used in only 7% of cases.

Conclusions:

• Slowly absorbable synthetic mesh demonstrates comparable outcomes to permanent and biologic mesh in contaminated ventral hernia repairs.
• Optimal retro-rectus repair may enhance the performance of slowly absorbable mesh.
• Findings suggest slowly absorbable synthetic mesh is a viable option in contaminated settings.