Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair

Abstract

Background: The introduction of mesh for reinforcement of ventral hernia repair (VHR) led to a significant reduction in hernia recurrence rates. However, it remains controversial whether synthetic or biologic mesh leads to superior outcomes. Recently, hybrid mesh consisting of reinforced biosynthetic ovine rumen (RBOR) has been developed and aims to combine the advantages of biologic and synthetic mesh; however, outcomes after VHR with RBOR have not yet been compared with the standard of care. Methods: We performed a retrospective analysis on 109 patients, who underwent VHR with RBOR (n = 50) or synthetic polypropylene mesh (n = 59). Demographic characteristics, comorbidities, postoperative complications, and recurrence rates were analyzed and compared between the groups. Multivariate logistic regression models were fit to assess associations of mesh type with overall complications and surgical site occurrence (SSO). Results: Patients who underwent VHR with RBOR were older (mean age 63.7 versus 58.8 years, P = 0.02) and had a higher rate of renal disease (28.0 versus 10.2%, P = 0.01) compared with patients with synthetic mesh. Despite an unfavorable risk profile, patients with RBOR had lower rates of SSO (16.0 versus 30.5%, P = 0.12) and similar hernia recurrence rates (4.0 versus 6.78%, P = 0.68) compared with patients with synthetic mesh. The use of synthetic mesh was significantly associated with higher odds for overall complications (3.78, P < 0.05) and SSO (3.87, P < 0.05). Conclusion: Compared with synthetic polypropylene mesh, the use of RBOR for VHR mitigates SSO while maintaining low hernia recurrence rates at 30-month follow-up.

Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair: Erratum

“…Two errors have been reported by the authors of "Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair," published as e4707 in Plastic and Reconstructive Surgery Global Open, by Sivaraj et al 1 On page 5, left-hand column, first paragraph, second line from the top: "Gore's Synecore (polytetrafluorethylene fibers combined with a bioabsorbable copolymer scaffold composed of polyglycolic acid and trimethylene carbonate)" should be changed to "GORE BIO-A (bioabsorbable copolymer scaffold composed of polyglycolic acid and trimethylene carbonate). "…”

“…Two errors have been reported by the authors of “Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair,” published as e4707 in Plastic and Reconstructive Surgery Global Open , by Sivaraj et al 1…”

Comment to: Comparison of mechanical properties and host tissue response to OviTex™ and Strattice™ surgical meshes

“…We would like to bring to the readers’ attention the published clinical investigations of Sivaraj et al [ 2 ] and Goetz et al [ 3 ], among several others [ 4 – 6 ]. Sivaraj et al compared clinical outcomes following ventral hernia repair with either Ovitex (n = 36) or Strattice (n = 51) along with several other biologic products.…”