POLY-4-HYDROXYBUTYRATE MESH (PHASIX MESH) FOR VENTRAL HERNIA REPAIRS: A SINGLE SURGEON RETROSPECTIVE SERIES

Abstract Aim To compare a single-surgeon experience using poly-4-hydroxybutyrate mesh (Phasix™ Mesh) for ventral hernia repairs (VHR). Material and Methods A retrospective series was performed from 2014-2020. Inclusion criteria were patients ≥18 years of age with open VHR using poly-4-hydroxybutyrate mesh, with a minimum follow-up of 12-months. Comparisons were performed between no prior VHR versus prior VHR; no mesh infections versus mesh infections; onlay versus retrorectus; no recurrences versus recurrences; no readmissions versus readmissions; no reoperations versus reoperations. Results Poly-4-hydroxybutyrate mesh was used for VHR in 179 patients. Compared to 90 patients with no prior VHR, 89 patients with prior VHR had higher BMIs (31.1kg/m2versus33.3 kg/m2; p = 0.042). Compared to 146 patients with no mesh infections, 33 patients with mesh infections had more prior VHR (97%versus39%; p < 0.001). Compared to 101 patients with onlay approaches, 79 patients with retrorectus approaches had more component separations (89%versus31%; p < 0.001). Compared to 168 patients with no recurrences, 11 patients with recurrences had more complications (55%versus23%; p = 0.031), reoperations (82%versus16%; p < 0.001), and readmissions (91%versus20%; p < 0.001). Compared to 136 patients with no readmissions, 43 patients with readmissions had more hypertension (81%versus56%; p = 0.004), COPD (28%versus10%; p = 0.011), complications (79%versus8%; p < 0.001), and recurrences (23%versus0.7%; p < 0.001). Compared to 142 patients with no reoperations, 37 patients with reoperations had more hypertension (89%versus55%; p < 0.008), diabetes (43%versus25%; p = 0.042), COPD (30%versus11%; p = 0.007), hyperlipidemia (57%versus32%; p = 0.008), larger defect sizes (300cm2versus200cm2; p = 0.032), complications (78%versus11%; p < 0.001), readmissions (92%versus6%; p < 0.001), and recurrences (24%versus1%; p < 0.001). Conclusions VHR with poly-4-hydroxybutyrate mesh can include prior VHR, different anatomical locations, mesh infections, recurrences, readmissions and reoperations.