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Short-term outcomes of heavyweight versus mediumweight synthetic mesh in a retrospective cohort of clean-contaminated and contaminated retromuscular ventral hernia repairs.
- Source :
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Surgical endoscopy [Surg Endosc] 2024 Jul; Vol. 38 (7), pp. 4006-4013. Date of Electronic Publication: 2024 Jun 11. - Publication Year :
- 2024
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Abstract
- Background: Mediumweight (40-60 g/m <superscript>2</superscript> ) polypropylene (MWPP) mesh has been shown to be safe and effective in CDC class II-III retromuscular ventral hernia repairs (RMVHR). However, MWPP has the potential to fracture, and it is possible that heavyweight (> 75 g/m <superscript>2</superscript> ) polypropylene mesh has similar outcomes in this context. However, there is limited data on HWPP mesh performance in clean-contaminated and contaminated scenarios. We aimed to compare HWPP to MWPP mesh in CDC class II-III wounds during open RMVHR.<br />Methods: The Abdominal Core Health Quality Collaborative database was retrospectively queried for a cohort of patients who underwent open RMVHR with MWPP or HWPP mesh placed in CDC class II/III wounds from 2012 to 2023. Mesh types were compared using a 3:1 propensity score-matched analysis. Covariates for matching included CDC classification, BMI, diabetes, smoking within 1 year, hernia, and mesh width. Primary outcome of interest included wound complications. Secondary outcomes included reoperations and readmissions at 30 days.<br />Results: A total of 1496 patients received MWPP or HWPP (1378 vs. 118, respectively) in contaminated RMVHR. After propensity score matching, 351 patients remained in the mediumweight and 117 in the heavyweight mesh group. There were no significant differences in surgical site infection (SSI) rates (13.4% vs. 14.5%, p = 0.877), including deep SSIs (0.3% vs. 0%, p = 1), surgical site occurrence rates (17.9% vs. 22.2%, p = 0.377), surgical site occurrence requiring procedural intervention (16% vs. 17.9%, p = 0.719), mesh removal (0.3% vs. 0%, p = 1), reoperations (4.6% vs. 2.6%, p = 0.428), or readmissions (12.3% vs. 9.4%, p = 0.504) at 30 days.<br />Conclusion: HWPP mesh was not associated with increased wound morbidity, mesh excisions, reoperations, or readmissions in the early postoperative period compared with MWPP mesh in open RMVHR for CDC II/III cases. Longer follow-up will be necessary to determine if HWPP mesh may be a suitable alternative to MWPP mesh in contaminated scenarios.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Retrospective Studies
Male
Female
Middle Aged
Aged
Treatment Outcome
Patient Readmission statistics & numerical data
Reoperation statistics & numerical data
Postoperative Complications epidemiology
Postoperative Complications etiology
Hernia, Ventral surgery
Surgical Mesh adverse effects
Herniorrhaphy methods
Herniorrhaphy adverse effects
Polypropylenes
Surgical Wound Infection epidemiology
Surgical Wound Infection etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 38
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 38862822
- Full Text :
- https://doi.org/10.1007/s00464-024-10946-0