Abstract

Abstract Aim Bio-synthetic meshes potentially disappear from the body after certain timeframe leaving behind strengthening scaffold matrix when used for Complex Abdominal Wall Reconstruction (CAWR). We used Carolinas comfort scale (CCS) to assess mesh sensation differences between biosynthetic and synthetic mesh at different time points. Material and Methods This pilot study focusses on patients having undergone CAWR within the unit in the last 3 years. Patients were categorised into four groups of 10 patients each; those repaired with synthetic mesh or biosynthetic mesh within the last 8 months and beyond 18 months. All 40 patients answered all questions of the Carolinas CCS. Decision of mesh type was governed by patient characteristics. Results 10 patients were included in each group (total 40 patients) consecutive retrospective enrolment. We excluded those who had further abdominal surgery or clinical recurrence since. 20 patients repaired with biosynthetic and 20 with synthetic were included. Two-way ANOVA and post HOC Turkey's difference test showed significant difference (p<0.05) in scores in favour of less scores for patients repaired with biosynthetic mesh. This was more pronounced in the beyond 18 month group. Component separation did not make a significant difference in mesh sensation. Logistic Regression analysis revealed patients scored higher on questions related to bending, sitting up and exercise and these were linked. 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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