Evaluation of medium to long-term patient satisfaction following open midline incisional hernia repair

Patient-reported outcome measures (PROMs) are increasingly recognised as one of the most important metrics for assessment of outcomes after abdominal wall hernia repair. The study aim was to evaluate patient satisfaction using 4 different PROMS following open repair of midline incisional hernias.

Patients with no recurrence or significant surgical site infection (SSI) after midline incisional hernia retromuscular mesh repair and concurrent abdominoplasty were invited to complete four PROMs: the Carolinas Comfort Scale (CCS, range 0-115), Brehaut decision regret scale (BDRS, range 20-100), Abdominoplasty questionnaire (Q-PROM, range 7-28) and Patient Scar Assessment Scale (PSAS; range 6-60).

50 out of 72 responses were received and analysed. The mean age of respondents was 60.6 years. The mean time to assess PROMs responses was 41.4 (range, 12.0-83.9) months after the date of surgery. The mean CCS score was 11.36 (no or mild mesh-related post-operative symptoms), the mean PSAS score was 17.36 (the scar looked or felt moderately different to normal skin), the mean abdominoplasty score was 20.51 (patients were very satisfied with their post-operative body contour) and the mean BDRS score was 28.4 (patients either had no or minimal regret). Overall, there was 78% global satisfaction rate across the 4 PROMS.

The majority of patients had self-reported satisfactory outcomes and quality of life in the medium to long term, however despite no hernia recurrence or SSI a proportion remained dissatisfied and regretted their surgical decision. Embedding PROMs into follow-up regimes improves understanding of post-operative outcomes and should be considered at least as important as traditional outcome measures for hernia repair.