Outcomes of Open Complex Ventral Hernia Repairs With Retromuscular Placement of Poly-4-Hydroxybutyrate Bioabsorbable Mesh.

. Optimal technique and mesh selection still debated for complex ventral hernias. Limited data exists on bioabsorbable meshes in high-risk patients. We evaluated our experience. . Retrospective review was conducted following institutional review board approval for ventral hernia repairs using a single bioabsorbable mesh between February 2014 and November 2017. Patient and hernia details characterized. Outcomes evaluated. . 20 ventral hernia repairs identified, 10 males, 10 females. Mean body mass index was 35 ± 7.4 kg/m, and mean age 47 ± 13 years. Comorbid conditions were diabetes 35% and hypertension 40%. Fifty-five percent had American Society of Anesthesiologist scores of 3. : Ventral Hernia Working Group Grade 3 hernias were 80%, and remainder grade 2. Forty percent of hernias were Centers for Disease Control class III, and remainder were class I and II. The mean defect size was 533 cm ± 500. Repair for prior open abdomens was 45%, recurrent hernias 20%, incisional 15%, incarcerated 10%, incisional with parastomal 5%, and primary ventral 5%. Concomitant bowel procedures in 8, (40%). All cases had retromuscular mesh placement (transversus abdominus release 65%, Rives-Stoppa 35%). Surgical site occurrences were 20% (surgical site infection 10%, seroma 10%). Overall hospital stay 5 ± 3 days. Ileus occurred in 20%. One postoperative death due to fatal arrhythmia. There were no recurrences with mean follow-up 21.1 months. . Complex hernia repairs using bioabsorbable mesh were conducted in a small cohort of high-risk patients. These data demonstrate good outcomes with limited morbidity and mortality. There were no recurrences.