Abstract

Abstract Aim To compare Quality Of Life (QoL) outcomes amongst patients undergoing elective Open abdominal wall reconstruction (AWR) with Synthetic Mesh versus Biosynthetic mesh, using the Carolinas Comfort scale (CCS) questionnaire. Method This is a retrospective study with longitudinal prospective questionnaire extension of all patients who have undergone AWR within last four years by the same AWR surgeon and Plastic surgeon team with no recurrence. Four groups of patients were compared based on time from surgery (more or less than eight months) and use of synthetic or biosynthetic mesh. The rationale behind it is based on characteristics of the biosynthetic mesh data showing complete disappearance by eight-months and replacement by a scaffolding tissue as an ingrown matrix and collagen. Results There were eight patients in each group (total 32 patients). 16 patients had repair with Bio A mesh and 16 with Dynamesh CICAT. Using two-way ANOVA and post HOC Turkey’s difference test, we found a significantly lower score (p<0.05) in the patients who had a repair with the Bio Synthetic mesh. Maximum score on the CCS is 115 points but except for one outlier of 70 points, none of the remaining 31 patients had a score higher than 50. Patients scored higher on questions related to bending, sitting up and exercise. Conclusions This outcome provides a review of current surgical practises and meshes, helping surgeons & patients make better informed decisions. Bio-synthetic meshes have better comfort outcomes for patients with lower CCS scores in the long term.

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