P-073 RESORBABLE SYNTHETIC VS. BIOLOGIC MESH VENTRAL HERNIA REPAIR IN CONTAMINATED FIELDS

Abstract

Abstract Aim Abdominal wall reconstruction (AWR) with ventral hernia repair (VHR) in the setting of contamination poses unique and controversial challenges. The purpose of this study was to examine the efficacy of resorbable biosynthetic mesh against biologic mesh in contaminated VHR with AWR. Methods A single-center, retrospective review from 2015–2021 was performed examining subjects who underwent VHR with AWR in contaminated fields (CDC wound class II-IV). A matched paired analysis based on Age, BMI, and CDC wound class was conducted among patients who utilized resorbable biosynthetic mesh in an onlay fashion and biologic mesh in an underlay fashion. Results A total of 94 patients (47 per group) underwent VHR with AWR in contaminated fields. Patients who utilized biosynthetic mesh had an average defect size of 314.56 ± 214.65 cm2, required component separation (57.4%), and were often recurrent (61.7%). Majority of contamination were clean-contaminated (68.1%), followed by dirty/infected (19.1%), and contaminated (12.8%). Patients utilizing resorbable biosynthetic mesh experienced fewer surgical site occurrences (46.8% vs 72.3%, p <0.05) and fewer surgical site occurrence procedural interventions (19.1% vs. 38.4%, p<0.05). Patients with biosynthetic mesh had fewer hernia recurrences compared to biologic mesh use, however was not statistically significant (14.9% vs. 30.4%, p = 0.07), with a mean follow up of 25.73 ± 18.66 months. Conclusion Utilization of resorbable biosynthetic mesh may be preferable to biologic mesh in contaminated fields due to lower rates of surgical site occurrences and interventions, ultimately reducing the post-operative clinical and financial burden for this patient population.