Technique and Outcomes of Abdominal Incisional Hernia Repair Using a Synthetic Composite Mesh: A Report of 455 Cases

Abstract

Abdominal wall hernias are a frequent and formidable challenge for general surgeons. Several different surgical techniques and types of mesh prosthetics are available for repair. We evaluated outcomes of an open ventral hernia repair using a synthetic composite mesh. We prospectively collected data on consecutive patients undergoing open ventral hernia repair using a synthetic composite mesh from January 1, 2000 to December 31, 2005 at four large medical centers. Four surgeons used a standardized surgical procedure for all patients. The study consisted of 455 patients with an average age of 56 years; 54% were men. Sixty-nine percent of the patients underwent repairs for recurrent hernias. Mean defect size was 44 cm(2), and mean mesh size was 213 cm(2). Average length of hospital stay was 1.1 days. Thirty-one patients had 33 early complications (7%), and 3 patients (0.7%) required reoperation (one each for seroma, bowel injury, and wound breakdown). Early infection occurred in four patients (0.9%), and one patient required reoperation and graft removal. Late complications occurred in nine patients (2%), with two patients requiring reoperation. Late infections occurred in two patients (0.4%); both required antibiotic treatment. Recurrent hernias were observed in 6 patients (1%; 6 of 450 because of 5 patients with unknown recurrence) at a mean followup of 29.3 months. In this large multicenter series, open ventral hernia repair using a composite mesh resulted in a short hospital stay, moderate complication rate, low infection rate, and low recurrence rate.