Background: There are many materials available for the reinforcement of complex abdominal wall reconstruction, including permanent synthetic, biologic, and absorbable synthetic meshes. The recurrence rate of complex hernia repairs beyond 5 years has not been reported. We hypothesized that the use of absorbable synthetic mesh in clean wounds would yield favorable long-term outcomes.
Study Design: Patients who underwent open complex ventral hernia repair with clean wounds (CDC class 1) using absorbable synthetic mesh (Bio-A, Gore, Flagstaff, AZ) in the retrorectus position were retrospectively reviewed. Chart review and a validated telephone questionnaire to screen for recurrence were utilized to evaluate and document hernia recurrence.
Results: A total of 49 patients were included in this study. Patients were followed for recurrences for up to 105 months, with a mean follow-up time of 62.4 months (5.2 years). The total number of midline hernia recurrence was 7 out of the original 49 patients (14%). The mean and median recurrence time are 37.4 and 38.8 months, respectively. Kaplan-Meier survival analysis estimated hernia recurrence rate as 2%, 4.6%, 7.1%, 12%, 15%, and 18% at 12, 24, 36, 48, 60, and 72 months, respectively.
Conclusion: The use of absorbable synthetic mesh in clean wound ventral hernia repair resulted in favorable long-term recurrence rates. The recurrence rate of absorbable synthetic mesh is similar to that of permanent synthetic mesh, which gives a viable option for patients in whom permanent synthetic mesh is not an option.
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