Synthetic Versus Biologic Mesh for Complex Open Ventral Hernia Repair: 3-Year Follow-Up of a Pilot Randomized...

Area of Science:

• Surgical innovation and evidence-based practice in reconstructive surgery.
• Biomaterials science and clinical application in hernia repair.

Background:

• Biologic mesh is increasingly used in complex hernia repair, but robust clinical evidence is limited.
• The efficacy and safety of biologic mesh versus synthetic mesh in challenging cases require further investigation.

Purpose of the Study:

• To compare clinical and patient-reported outcomes of biologic versus synthetic mesh in complex open ventral hernia repair (OVHR) at a 3-year follow-up.
• To evaluate the long-term effectiveness and safety of different mesh materials in a high-risk surgical population.

Main Methods:

• A single-center, randomized controlled pilot trial comparing biologic and synthetic mesh in complex OVHR.
• Primary outcomes included major complications (infections, recurrences, reoperations, deaths); secondary outcomes assessed surgical site infections and patient-reported outcomes.
• Outcomes were analyzed using frequentist generalized linear models at 3-year follow-up.

Main Results:

• No significant differences were observed in major complications (50% vs. 30%, P=.123) between biologic and synthetic mesh groups.
• Rates of mesh infection (14% vs. 3%), recurrence (39% vs. 24%), reoperation (14% vs. 9%), and mortality (4% vs. 0%) were not significantly different.
• Both groups reported clinically important improvements in quality of life and pain scores at 3 years.

Conclusions:

• This study found no clinical benefit of using biologic mesh over synthetic mesh for complex OVHR at 3 years.
• Biologic mesh did not demonstrate superiority in terms of major complications, recurrences, or patient-reported outcomes compared to synthetic mesh.
• Further research may be needed to identify specific indications for biologic mesh in complex hernia repair.